Provider Demographics
NPI:1811179682
Name:WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC.
Entity type:Organization
Organization Name:WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-907-5491
Mailing Address - Street 1:16311 VENTURA BLVD STE 977
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:435 ORANGE SHOW LN STE 105
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2015
Practice Address - Country:US
Practice Address - Phone:909-380-7740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21081103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty