Provider Demographics
NPI:1407339237
Name:KARAMANUKYAN, ANNIE HEIDI
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:HEIDI
Last Name:KARAMANUKYAN
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 1:740 FRONT ST STE 130
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4536
Mailing Address - Country:US
Mailing Address - Phone:818-643-1772
Mailing Address - Fax:
Practice Address - Street 1:740 FRONT ST STE 130
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4536
Practice Address - Country:US
Practice Address - Phone:831-295-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist