Provider Demographics
NPI:1942916135
Name:DEPANIAN, SILVA ANI
Entity Type:Individual
Prefix:
First Name:SILVA
Middle Name:ANI
Last Name:DEPANIAN
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 1:15233 VENTURA BLVD STE 1208
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2271
Mailing Address - Country:US
Mailing Address - Phone:818-396-6376
Mailing Address - Fax:
Practice Address - Street 1:15233 VENTURA BLVD STE 1208
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2271
Practice Address - Country:US
Practice Address - Phone:818-396-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC121864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health