Provider Demographics
NPI:1356689558
Name:STEPANYAN, LIANA
Entity Type:Individual
Prefix:MISS
First Name:LIANA
Middle Name:
Last Name:STEPANYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:328 W PALMER AVE
Mailing Address - Street 2:#2
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2230
Mailing Address - Country:US
Mailing Address - Phone:818-476-8443
Mailing Address - Fax:
Practice Address - Street 1:328 W PALMER AVE
Practice Address - Street 2:#2
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2230
Practice Address - Country:US
Practice Address - Phone:818-476-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst