Provider Demographics
NPI:1629401781
Name:XINTARIANOS, ELIZABETH ASTGHIG (MSW)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:ASTGHIG
Last Name:XINTARIANOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 ADMIRALTY WAY
Mailing Address - Street 2:SUITE 1122
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6905
Mailing Address - Country:US
Mailing Address - Phone:626-379-8226
Mailing Address - Fax:
Practice Address - Street 1:4712 ADMIRALTY WAY
Practice Address - Street 2:SUITE 1122
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6905
Practice Address - Country:US
Practice Address - Phone:626-379-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program