Provider Demographics
NPI:1497136527
Name:TANIELIAN, ALINE ZARIG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALINE
Middle Name:ZARIG
Last Name:TANIELIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4004 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4929 WILSHIRE BLVD
Practice Address - Street 2:SUITE NUMBER 510
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3808
Practice Address - Country:US
Practice Address - Phone:562-904-3999
Practice Address - Fax:855-688-6746
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY27258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical