Provider Demographics
NPI:1356969109
Name:AVEDISSIAN, MARIA (LMFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:AVEDISSIAN
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 1:2512 FOOTHILL BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3506
Mailing Address - Country:US
Mailing Address - Phone:626-348-1620
Mailing Address - Fax:
Practice Address - Street 1:2512 FOOTHILL BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3506
Practice Address - Country:US
Practice Address - Phone:626-348-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134172106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist