Provider Demographics
NPI:1164223566
Name:RAWAT, JYOTI
Entity type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:RAWAT
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 1:4401 SEPULVEDA BLVD UNIT 408
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3937
Mailing Address - Country:US
Mailing Address - Phone:310-947-1468
Mailing Address - Fax:
Practice Address - Street 1:16600 SHERMAN WAY STE 270
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3775
Practice Address - Country:US
Practice Address - Phone:888-795-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152195106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist