Healthcare Provider Details

I. General information

NPI: 1013146646
Provider Name (Legal Business Name): CHRISTINE POURANDRIAS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 N CENTRAL AVE
GLENDALE CA
91203-2531
US

IV. Provider business mailing address

237 N CENTRAL AVE
GLENDALE CA
91203-2531
US

V. Phone/Fax

Practice location:
  • Phone: 818-547-9544
  • Fax:
Mailing address:
  • Phone: 818-547-9544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: