Provider Demographics
NPI:1861854309
Name:YAYMADJIAN, IRENE (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:YAYMADJIAN
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15030 VENTURA BLVD # 673
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5470
Mailing Address - Country:US
Mailing Address - Phone:818-261-7486
Mailing Address - Fax:
Practice Address - Street 1:4521 SHERMAN OAKS AVE STE 101
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3807
Practice Address - Country:US
Practice Address - Phone:747-777-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CALMFT103952106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist