Provider Demographics
NPI:1194153064
Name:NAVES, GEORGE
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:NAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 N NAOMI ST APT B
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3234
Mailing Address - Country:US
Mailing Address - Phone:818-317-8670
Mailing Address - Fax:661-554-7071
Practice Address - Street 1:25101 THE OLD RD STE 131
Practice Address - Street 2:
Practice Address - City:STEVENSON RANCH
Practice Address - State:CA
Practice Address - Zip Code:91381-2206
Practice Address - Country:US
Practice Address - Phone:818-317-8670
Practice Address - Fax:661-554-7071
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT101327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist