Provider Demographics
NPI:1174250682
Name:OUZENIAN, ALICE MARY
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:MARY
Last Name:OUZENIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832 JOAQUIN DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1827
Mailing Address - Country:US
Mailing Address - Phone:626-597-5156
Mailing Address - Fax:818-337-2017
Practice Address - Street 1:2832 JOAQUIN DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-1827
Practice Address - Country:US
Practice Address - Phone:626-597-5156
Practice Address - Fax:818-337-2017
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)