Provider Demographics
NPI:1093929135
Name:CHITILIAN, NORA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:
Last Name:CHITILIAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3734 LA CRESCENTA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1023
Mailing Address - Country:US
Mailing Address - Phone:818-634-1063
Mailing Address - Fax:
Practice Address - Street 1:320 ARDEN AVE STE 240
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1170
Practice Address - Country:US
Practice Address - Phone:818-634-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSIX562OtherDMH