Souris, Mark John
Souris, Mark John is an sole proprietor health care provider with primary practice located at 21243 Ventura Blvd Suite 207, Woodland Hills CA 91364-2109. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Souris, Mark John can be contacted via phone (818) 635-9705.Contact Information
Primary practice address
21243 Ventura Blvd Suite 207
Woodland Hills CA 91364-2109
Phone: (818) 635-9705
Fax: (747) 300-9246
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY14283 | California |
Profile Details
NPI number | 1003098427 |
---|---|
LBN Legal business name | Souris, Mark John |
Credentials | PSYD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 27th, 2007 |
Last updated | Nov 17th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1003098427 | NPPES |
California | Other | 14283 | LICENSE NUMBER |
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