Provider Demographics
NPI:1427498468
Name:ISRAYELYAN, JANE (LICENSED MARRIAGE AN)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:ISRAYELYAN
Suffix:
Gender:F
Credentials:LICENSED MARRIAGE AN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100-190 RANCHO RD #282
Mailing Address - Street 2:516 PENNSFIELD PL. #100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:323-809-3854
Mailing Address - Fax:
Practice Address - Street 1:516 PENNSFIELD PL. #100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-608-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARS6535101YA0400X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)