Provider Demographics
NPI:1407997612
Name:VARBEDIAN, ANI MANUKYAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANI
Middle Name:MANUKYAN
Last Name:VARBEDIAN
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 1:11145 TAMPA AVE
Mailing Address - Street 2:SUITE 27A
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2255
Mailing Address - Country:US
Mailing Address - Phone:818-336-1603
Mailing Address - Fax:
Practice Address - Street 1:11145 TAMPA AVE
Practice Address - Street 2:SUITE 27A
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2255
Practice Address - Country:US
Practice Address - Phone:818-336-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46592106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist