NORTHSTAR DETOX & REHAB CENTER, LLC (NPI# 1326669011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326669011 |
| Entity Type | Organization |
| Organization Name | NORTHSTAR DETOX & REHAB CENTER, LLC |
| Practice Address |
19500 Winifred St Tarzana CA 91356-3815 |
| Practice Telephone | 8189282042 |
| Practice Fax Number | 8189282043 |
| Mailing Telephone | 8189282042 |
| Mailing Fax Number | 8189282043 |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |
| Authorized Official Name | HOSSEIN JOUKAR (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3053191133 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
19500 WINIFRED ST |
| City | TARZANA |
| State | CA |
| Zip Code | 91356-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679137293 | Sarah Badreau | Behavior Technician | 5554 Reseda Blv., Tarzana, CA 91356 | 2019-04-29 |
| 1831661966 | Daraie Dental Group Inc | Dentist | 5620 Wilbur Avenue Ste 300, Tarzana, CA 91356 | 2018-12-31 |
| 1982182770 | Blanca Garay | Respiratory Therapist, Registered | 18214 Burbank Blvd Apt 120, Tarzana, CA 91356 | 2018-08-02 |
| 1437659000 | Chloe Kang | Speech-Language Pathologist | 19019 Ventura Blvd., Tarzana, CA 91356 | 2018-02-20 |
| 1114430139 | Avb & Lv Corporation | Home Health | 18340 Ventura Blvd Ste 220, Tarzana, CA 91356 | 2017-11-13 |
| 1881110468 | Samina Qadir | Registered Nurse | 18321 Clark St., Tarzana, CA 91356 | 2017-08-16 |
| 1700306776 | Debbie Rehman Lux | Marriage & Family Therapist | 18370 Burbank Blvd., Suite 211, Tarzana, CA 91356 | 2017-06-21 |
| 1467980631 | Valley Nerological Services, LLC | Radiology | 5260 Wilbur Ave Ste 207, Tarzana, CA 91356 | 2017-05-31 |
| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1780130088 | Evolve Growth Initiatives, LLC | Clinic/Center | 5358 Vanalden Drive, Tarzana, CA 91356 | 2016-08-28 |
| Find all providers in zip 91356 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508289174 | Sara Bivans | Psychologist | 19562 Ventura Blvd, Suite 233, Tarzana, CA 91356-2955 | 2014-02-01 |
| 1225300114 | Julia Kirk | Psychologist | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2012-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293199 | Corinne Guerrero | Psychologist | 4820 Melrose Ave, Oakland, CA 94601-5346 | 2020-10-19 |
| 1326661331 | Dr Susan Shapiro Psychologist, Inc | Psychologist | 1647 S Hayworth Ave, Los Angeles, CA 90035-4513 | 2020-05-26 |
| 1548891443 | Catalyst Recovery LLC | Psychologist | 10250 Constellation Blvd Ste 100, Los Angeles, CA 90067-6272 | 2020-01-29 |
| 1932765336 | Mischka Psychological PC | Psychologist | 4468 Phelan Rd, Phelan, CA 92371-4098 | 2019-05-13 |
| 1851955181 | Matthew Taylor | Psychologist | 27645 E Trail Ridge Way Apt 1007, Moreno Valley, CA 92555-3122 | 2019-04-23 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1639640766 | Lidia Janette Aguilar | Psychologist | 4958 Gabrielieno Ave, Oceanside, CA 92057-4434 | 2018-12-16 |
| 1215428230 | Chances Counseling Centers LLC | Psychologist | 2727 N Bristol St, Santa Ana, CA 92706 | 2018-05-24 |
| 1295253953 | Raphael Gidharry Johnson | Psychologist | 1753 N. Country Ln., Pasadena, CA 91107-1104 | 2017-09-01 |
| 1417402066 | Aldo Ramirez | Psychologist | 1402 W Juniper St, Oxnard, CA 93033-3321 | 2016-08-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.