Provider Demographics
NPI:1023658333
Name:AGAJANIAN, EDUARD ARAM
Entity type:Individual
Prefix:
First Name:EDUARD
Middle Name:ARAM
Last Name:AGAJANIAN
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 1:708 CROCKETT AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4412
Mailing Address - Country:US
Mailing Address - Phone:408-394-8778
Mailing Address - Fax:
Practice Address - Street 1:150 EXECUTIVE PARK BLVD STE 2800
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-3311
Practice Address - Country:US
Practice Address - Phone:408-394-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst