Provider Demographics
NPI:1942951454
Name:VARZHAPETYAN, NADEZHDA NADIA
Entity Type:Individual
Prefix:
First Name:NADEZHDA
Middle Name:NADIA
Last Name:VARZHAPETYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15427 KESWICK ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-2009
Mailing Address - Country:US
Mailing Address - Phone:747-250-1427
Mailing Address - Fax:
Practice Address - Street 1:2101 N GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2828
Practice Address - Country:US
Practice Address - Phone:818-848-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty