Provider Demographics
NPI:1215361944
Name:GALADJIAN, LIANNA
Entity Type:Individual
Prefix:
First Name:LIANNA
Middle Name:
Last Name:GALADJIAN
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 1:855 N ORANGE GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3333
Mailing Address - Country:US
Mailing Address - Phone:626-796-3453
Mailing Address - Fax:626-744-3411
Practice Address - Street 1:855 N ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3333
Practice Address - Country:US
Practice Address - Phone:626-796-3453
Practice Address - Fax:626-744-3411
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW61884101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health