Provider Demographics
NPI:1346099637
Name:INFIELD, STEVEN MARK
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARK
Last Name:INFIELD
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 1:17631 VENTURA BLVD # 205
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3842
Mailing Address - Country:US
Mailing Address - Phone:213-944-8353
Mailing Address - Fax:
Practice Address - Street 1:28038 DOROTHY DR
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2687
Practice Address - Country:US
Practice Address - Phone:888-387-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health