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NPI Code Detail

MEDICARE: ELIZA KHANJIAN PHD

MEDICARE: ELIZA KHANJIAN PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistPSY19586CA
2103T00000XPsychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245390566
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZA KHANJIAN PHD
Provider Business Mailing Address
First Line : PO BOX 250
Second Line :
City : LA CANADA FLINTRIDGE
State : CA
Zip : 91012-0250
Country : US
Telephone Number : 818-396-5343
Fax Number : 818-561-3997
Provider Business Practice Location Address
First Line : 595 E COLORADO BLVD STE 205
Second Line :
City : PASADENA
State : CA
Zip : 91101-2028
Country : US
Telephone Number : 818-396-5343
Fax Number : 818-561-3997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 02/03/2025

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