Healthcare Provider Details

I. General information

NPI: 1144008889
Provider Name (Legal Business Name): JANET BAYRAMYAN LICENSED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 BALBOA BLVD STE 202
ENCINO CA
91316-1541
US

IV. Provider business mailing address

4804 LAUREL CANYON BLVD STE 284
VALLEY VILLAGE CA
91607-3717
US

V. Phone/Fax

Practice location:
  • Phone: 818-646-7190
  • Fax:
Mailing address:
  • Phone: 818-646-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JANET BAYRAMYAN
Title or Position: OWNER
Credential:
Phone: 818-646-7190