Provider Demographics
NPI:1972929123
Name:HARUTUNIAN, ANITA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:HARUTUNIAN
Suffix:
Gender:F
Credentials:LMFT
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 1704
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91209-1704
Mailing Address - Country:US
Mailing Address - Phone:818-523-6365
Mailing Address - Fax:
Practice Address - Street 1:335 MISSION RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-3327
Practice Address - Country:US
Practice Address - Phone:818-523-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46980106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist