Provider Demographics
NPI:1770611279
Name:SARKISSIAN-OURKHAN, ISABELLA (MA)
Entity type:Individual
Prefix:MRS
First Name:ISABELLA
Middle Name:
Last Name:SARKISSIAN-OURKHAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6331 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3403
Mailing Address - Country:US
Mailing Address - Phone:818-437-1476
Mailing Address - Fax:
Practice Address - Street 1:237 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2531
Practice Address - Country:US
Practice Address - Phone:818-547-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52992106H00000X
101YM0800X
CA78623106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health