Provider Demographics
NPI:1912380114
Name:OGANYAN, NAREK
Entity Type:Individual
Prefix:
First Name:NAREK
Middle Name:
Last Name:OGANYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 LAUREL CANYON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3238
Mailing Address - Country:US
Mailing Address - Phone:747-204-8884
Mailing Address - Fax:213-481-8279
Practice Address - Street 1:111 GLENDALE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5825
Practice Address - Country:US
Practice Address - Phone:213-481-8279
Practice Address - Fax:213-481-8279
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor