Provider Demographics
NPI:1336855576
Name:KORKOIAN, LAURA ANAHID (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANAHID
Last Name:KORKOIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 E ALTADENA DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2301
Mailing Address - Country:US
Mailing Address - Phone:818-416-8740
Mailing Address - Fax:
Practice Address - Street 1:609 E ALTADENA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2301
Practice Address - Country:US
Practice Address - Phone:818-416-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31298103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist