Individual provider · NPI-1

Ajenae La'Zae Burley

Community/Behavioral Health · Woodland Hills, CA

NPI number1235978891
StatusActive
Last updated in NPPESMay 23, 2024

Details

NPI
1235978891
Entity type
Individual (NPI-1)
Name
Ajenae La'Zae Burley
Sex
Female
Sole proprietor
Yes
Enumeration date
May 23, 2024
Certification date
May 23, 2024
Last updated
May 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

21600 Oxnard Street Suite 200
Woodland Hills, CA 91367

Phone 877-206-1009

Mailing address

21600 Oxnard Street Suite 200
Woodland Hills, CA 91367

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