Provider Demographics
NPI:1831423383
Name:SVOBODA, WENDI (LCSW)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:
Last Name:SVOBODA
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 1:4444 RIVERSIDE DRIVE
Mailing Address - Street 2:SUITE #105
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-288-6711
Mailing Address - Fax:818-846-7055
Practice Address - Street 1:4444 RIVERSIDE DRIVE
Practice Address - Street 2:SUITE #105
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-288-6711
Practice Address - Fax:818-846-7055
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS24639104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker