Provider Demographics
NPI:1518443886
Name:MARTIROSIAN, ROCHELLE
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:
Last Name:MARTIROSIAN
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 1:12456 VENTURA BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2484
Mailing Address - Country:US
Mailing Address - Phone:818-913-1787
Mailing Address - Fax:
Practice Address - Street 1:12456 VENTURA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2484
Practice Address - Country:US
Practice Address - Phone:818-913-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist