Via Avanta

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

172V00000X Issued in CA

Legal business name

VIA AVANTA

Practice address

4760 Sepulveda Blvd
Culver City, CA 90230

Phone

(310) 390-6612

NPI assigned

Mar 13, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mayli Eunice Torres

Title

Assistant Counsler

Phone

(818) 561-9415

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1639610462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIA AVANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "MAYLI",
        "authorized_official_middle_name": "EUNICE",
        "authorized_official_title_or_position": "ASSISTANT COUNSLER",
        "authorized_official_telephone_number": "818-561-9415"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "172V00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ventura, MED, BCBA
• Jonathan Ventura
• Jessica Vera
• Soledad Vergara
• Sameer Verma, M.D.
• Via Care Community Health Center
• Jolee Mae Vibar
• Vibrantcare Outpatient Rehabilitation Inc
• Rajiv Vijayakumar, P.T., D.P.T., M.S.
• Pedro Arturo Villa

• Community Health Clinic/Center in Culver City, CA
• Providers in Culver City, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.