Provider Demographics
NPI:1073370912
Name:ARUTYUNYAN, ARTEM SR
Entity Type:Individual
Prefix:MR
First Name:ARTEM
Middle Name:
Last Name:ARUTYUNYAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 VILLAGE DR UNIT 206
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-3073
Mailing Address - Country:US
Mailing Address - Phone:820-946-9401
Mailing Address - Fax:
Practice Address - Street 1:1095 VILLAGE DR UNIT 206
Practice Address - Street 2:
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-3073
Practice Address - Country:US
Practice Address - Phone:820-946-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)