Provider Demographics
NPI:1912576729
Name:AGOPIAN, SEAN (PSYD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:AGOPIAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2006
Mailing Address - Country:US
Mailing Address - Phone:626-222-1054
Mailing Address - Fax:
Practice Address - Street 1:2200 W 3RD ST STE 500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1938
Practice Address - Country:US
Practice Address - Phone:626-222-1054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical