Healthcare Provider Details

I. General information

NPI: 1548364011
Provider Name (Legal Business Name): NORA I SAHAKIAN PH D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORA SOUREN ISRAELIAN-KASPARIAN PH D

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BRAND BLVD STE 210
GLENDALE CA
91203-2641
US

IV. Provider business mailing address

1312 EL HITO CIR
PACIFIC PALISADES CA
90272-2336
US

V. Phone/Fax

Practice location:
  • Phone: 818-240-1065
  • Fax: 818-240-1065
Mailing address:
  • Phone: 818-240-1065
  • Fax: 818-240-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY16606
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY16606
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPSY16606
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: