Provider Demographics
NPI:1245902360
Name:ZAKEVOSYAN, ASTGHIK
Entity type:Individual
Prefix:
First Name:ASTGHIK
Middle Name:
Last Name:ZAKEVOSYAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15260 VENTURA BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5347
Mailing Address - Country:US
Mailing Address - Phone:661-400-0586
Mailing Address - Fax:
Practice Address - Street 1:15260 VENTURA BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5347
Practice Address - Country:US
Practice Address - Phone:866-963-7396
Practice Address - Fax:866-461-0037
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT154380106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist