Provider Demographics
NPI:1679834550
Name:ABRAHAMIAN, TAKOOSH (MFT)
Entity Type:Individual
Prefix:
First Name:TAKOOSH
Middle Name:
Last Name:ABRAHAMIAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:ABRAHAMIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:9700 RESEDA BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-5504
Mailing Address - Country:US
Mailing Address - Phone:818-644-9920
Mailing Address - Fax:818-337-0440
Practice Address - Street 1:15339 SATICOY ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3345
Practice Address - Country:US
Practice Address - Phone:818-267-2781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107440106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA69936OtherBOARD OF BEHAVIORAL SCIENCE