Provider Demographics
NPI:1699932004
Name:ZHITNITSKY, NATALIE (SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ZHITNITSKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20720 VENTURA BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-6261
Mailing Address - Country:US
Mailing Address - Phone:818-708-7704
Mailing Address - Fax:818-708-7707
Practice Address - Street 1:20720 VENTURA BLVD STE 260
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-6261
Practice Address - Country:US
Practice Address - Phone:818-708-7704
Practice Address - Fax:818-708-7707
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACCC9644235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA704362OtherACN PROVIDER
CACCC9644OtherLICENSE
CAZZZ67240ZOtherBLUE SHIELD
CAW19128Medicare Oscar/Certification
CABY473ZMedicare UPIN