Provider Demographics
NPI:1548386576
Name:AIZIC, RAMI (JD, MFT)
Entity Type:Individual
Prefix:MR
First Name:RAMI
Middle Name:
Last Name:AIZIC
Suffix:
Gender:M
Credentials:JD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2022
Mailing Address - Country:US
Mailing Address - Phone:310-278-8668
Mailing Address - Fax:310-278-8468
Practice Address - Street 1:9730 WILSHIRE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2022
Practice Address - Country:US
Practice Address - Phone:310-278-8668
Practice Address - Fax:310-278-8468
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist