Mark John Souris
Clinical Psychologist
21243 Ventura Blvd Suite 207
Woodland Hills
, California 91364-2109
Mark John Souris
Clinical Psychologist
21243 Ventura Blvd Suite 207
Woodland Hills
, California 91364-2109
(747) 300-9246
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Mark John Souris
- 19701 Tuba St
- Chatsworth, CA
- Zip : 91311-3547
- Fax : (747) 300-9246
- Phone : (818) 635-9705
Second Address
- Mark John Souris
- 21243 Ventura Blvd Suite 207
- Woodland Hills, CA
- Zip : 91364-2109
- Fax : (747) 300-9246
- Phone : (818) 635-9705
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | PSY14283 | CA |
| Y | 103TC0700X | Clinical Psychologist | PSY14283 | CA |
National Provider Identifier
| NPI | 1003098427 |
|---|---|
| Provider Name | Mark John Souris |
| First Address | Chatsworth, CA 91311-3547 |
| Second Address | Woodland Hills, CA 91364-2109 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/11/2007 |
| Last Update Date | 17/11/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 14283 | LICENSE NUMBER (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.