Provider Demographics
NPI:1619484854
Name:YAGHOUBIAN, PAULINA (DPT)
Entity Type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:
Last Name:YAGHOUBIAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20241 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4731
Mailing Address - Country:US
Mailing Address - Phone:818-205-4936
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4724
Practice Address - Country:US
Practice Address - Phone:310-984-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist