Provider Demographics
NPI:1477891000
Name:MOMJYAN, NONA NANA
Entity Type:Individual
Prefix:
First Name:NONA
Middle Name:NANA
Last Name:MOMJYAN
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 1:128 OLIVE ST
Mailing Address - Street 2:APT #A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-5626
Mailing Address - Country:US
Mailing Address - Phone:818-397-1769
Mailing Address - Fax:
Practice Address - Street 1:128 OLIVE ST
Practice Address - Street 2:APT #A
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-5626
Practice Address - Country:US
Practice Address - Phone:818-397-1769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor