Provider Demographics
NPI:1134819279
Name:HARUTUNIAN, ARA WILLIAM I (CATC 1)
Entity type:Individual
Prefix:MR
First Name:ARA
Middle Name:WILLIAM
Last Name:HARUTUNIAN
Suffix:I
Gender:M
Credentials:CATC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 SEPULVEDA BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1126
Mailing Address - Country:US
Mailing Address - Phone:818-779-0555
Mailing Address - Fax:
Practice Address - Street 1:6265 SEPULVEDA BLVD STE 9
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1126
Practice Address - Country:US
Practice Address - Phone:213-298-4146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21134631101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)