Provider Demographics
NPI:1841786779
Name:PAVLOGIANIS, JOHANNA EMILIA
Entity Type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:EMILIA
Last Name:PAVLOGIANIS
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:PO BOX 2094
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91979-2094
Mailing Address - Country:US
Mailing Address - Phone:818-921-6305
Mailing Address - Fax:
Practice Address - Street 1:41 E FOOTHILL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2361
Practice Address - Country:US
Practice Address - Phone:626-701-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist