Provider Demographics
NPI:1578022745
Name:CHITRAKUL, SAPATSANUN
Entity Type:Individual
Prefix:
First Name:SAPATSANUN
Middle Name:
Last Name:CHITRAKUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21243 VENTURA BLVD STE 118
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2162
Mailing Address - Country:US
Mailing Address - Phone:818-979-0065
Mailing Address - Fax:
Practice Address - Street 1:21243 VENTURA BLVD STE 118
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2162
Practice Address - Country:US
Practice Address - Phone:818-979-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
109305106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist