Provider Demographics
NPI:1790817849
Name:KAZARYAN, KARINA
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:KAZARYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 FORSYTHE ST
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2314
Mailing Address - Country:US
Mailing Address - Phone:818-497-0195
Mailing Address - Fax:
Practice Address - Street 1:23501 PARK SORRENTO STE 214
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1380
Practice Address - Country:US
Practice Address - Phone:818-497-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC49561106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist