Provider Demographics
NPI:1790330587
Name:NAZARYAN, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:NAZARYAN
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 1:10130 SEPULVEDA BLVD APT 18
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2632
Mailing Address - Country:US
Mailing Address - Phone:818-913-5334
Mailing Address - Fax:
Practice Address - Street 1:10200 SEPULVEDA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2656
Practice Address - Country:US
Practice Address - Phone:818-913-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34242355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant