Organization
ICAN-B
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE DAVILA PH.D. (CHIEF CLINICAL DIRECTOR)
(213) 215-3628
Entity
Organization
Contact information
Practice address
7141 WOODLEY AVE, VAN NUYS, CA 91406
(818) 285-8252
(818) 273-1831
Mailing address
7141 WOODLEY AVE, VAN NUYS, CA 91406
(818) 285-8252
(818) 273-1831
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/14/2015
Last updated
08/15/2025
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