Provider Demographics
NPI:1669017323
Name:KHATCHETOURIAN, BIAYNA
Entity type:Individual
Prefix:
First Name:BIAYNA
Middle Name:
Last Name:KHATCHETOURIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 SUNLAND BLVD APT 20
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2065
Mailing Address - Country:US
Mailing Address - Phone:818-967-7741
Mailing Address - Fax:
Practice Address - Street 1:425 W BROADWAY STE 450
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1366
Practice Address - Country:US
Practice Address - Phone:818-539-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst