Provider Demographics
NPI:1770985657
Name:AFSHIN, ANDREW CYRUS (MA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CYRUS
Last Name:AFSHIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:CYRUS
Other - Middle Name:
Other - Last Name:AFSHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 280476
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91328-0476
Mailing Address - Country:US
Mailing Address - Phone:818-518-3589
Mailing Address - Fax:
Practice Address - Street 1:301 E GLENOAKS BLVD STE 8
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-2117
Practice Address - Country:US
Practice Address - Phone:818-518-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional