Healthcare Provider Details

I. General information

NPI: 1215348933
Provider Name (Legal Business Name): ANI MARTIKYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E HUNTINGTON DR STE 303
ARCADIA CA
91006-6257
US

IV. Provider business mailing address

444 E HUNTINGTON DR STE 303
ARCADIA CA
91006-6257
US

V. Phone/Fax

Practice location:
  • Phone: 626-639-8844
  • Fax: 626-239-9866
Mailing address:
  • Phone: 626-639-8844
  • Fax: 626-239-9866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number97730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: