Provider Demographics
NPI:1922556695
Name:BOYER, VICTORIA (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11641 VALLEY SPRING LN APT 209
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2891
Mailing Address - Country:US
Mailing Address - Phone:773-729-7905
Mailing Address - Fax:
Practice Address - Street 1:2221 LINCOLN PARK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-2920
Practice Address - Country:US
Practice Address - Phone:773-729-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1096981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical