Provider Demographics
NPI:1891917993
Name:AVAZIAN, KARYN LORRAINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KARYN
Middle Name:LORRAINE
Last Name:AVAZIAN
Suffix:
Gender:F
Credentials:PSYD
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 54162
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-4162
Mailing Address - Country:US
Mailing Address - Phone:951-273-6200
Mailing Address - Fax:858-485-1563
Practice Address - Street 1:16644 W BERNARDO DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1901
Practice Address - Country:US
Practice Address - Phone:951-273-6200
Practice Address - Fax:858-485-1563
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12205103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist