Provider Demographics
NPI:1891934048
Name:OZERAN, LEON (PSYD)
Entity Type:Individual
Prefix:MR
First Name:LEON
Middle Name:
Last Name:OZERAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14621 TITUS ST
Mailing Address - Street 2:SUITE # 129
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4905
Mailing Address - Country:US
Mailing Address - Phone:818-994-2116
Mailing Address - Fax:818-781-5378
Practice Address - Street 1:1230 W 3RD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1408
Practice Address - Country:US
Practice Address - Phone:818-994-2116
Practice Address - Fax:818-781-5378
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical