Provider Demographics
NPI:1720106776
Name:LEVY, ARI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3716
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91394-0716
Mailing Address - Country:US
Mailing Address - Phone:818-831-8020
Mailing Address - Fax:818-831-8020
Practice Address - Street 1:CHILD & FAMILY CENTER
Practice Address - Street 2:21545 CENTRE POINTE PARKWAY
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350
Practice Address - Country:US
Practice Address - Phone:661-259-9439
Practice Address - Fax:661-259-9658
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical