Provider Demographics
NPI:1629336326
Name:ANTIKADJIAN, MARIA (LFMT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:ANTIKADJIAN
Suffix:
Gender:F
Credentials:LFMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 SHADELANDS DR BLDG 10
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2538
Mailing Address - Country:US
Mailing Address - Phone:818-497-2657
Mailing Address - Fax:818-475-1336
Practice Address - Street 1:2730 SHADELANDS DR BLDG 10
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2538
Practice Address - Country:US
Practice Address - Phone:818-497-2657
Practice Address - Fax:818-475-1336
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist