Provider Demographics
NPI:1831562412
Name:KAYEKJIAN, NAZIG (MS, MFT)
Entity type:Individual
Prefix:
First Name:NAZIG
Middle Name:
Last Name:KAYEKJIAN
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18250 ROSCOE BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4264
Mailing Address - Country:US
Mailing Address - Phone:818-623-7240
Mailing Address - Fax:818-998-6517
Practice Address - Street 1:16055 VENTURA BLVD STE 719
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2610
Practice Address - Country:US
Practice Address - Phone:818-623-7240
Practice Address - Fax:818-998-6517
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89709106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist