Provider Demographics
NPI:1790542942
Name:GEVORKYAN, AMALIYA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:AMALIYA
Middle Name:
Last Name:GEVORKYAN
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 1:401 N BRAND BLVD STE 236
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4443
Mailing Address - Country:US
Mailing Address - Phone:818-397-1118
Mailing Address - Fax:
Practice Address - Street 1:401 N BRAND BLVD STE 236
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4443
Practice Address - Country:US
Practice Address - Phone:818-397-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker