Provider Demographics
NPI:1932671518
Name:NAZARIAN, BITA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BITA
Middle Name:
Last Name:NAZARIAN
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 1:1209 AMHERST AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1152
Mailing Address - Country:US
Mailing Address - Phone:818-512-2172
Mailing Address - Fax:310-453-7755
Practice Address - Street 1:14540 VICTORY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1697
Practice Address - Country:US
Practice Address - Phone:818-512-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30440103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical