Healthcare Provider Details

I. General information

NPI: 1083313787
Provider Name (Legal Business Name): ELIZABETH PASHANIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 N BRAND BLVD STE 200
GLENDALE CA
91203-4617
US

IV. Provider business mailing address

138 N BRAND BLVD SUITE 200 UNIT# 336
GLENDALE, CA CA
91203-1644
US

V. Phone/Fax

Practice location:
  • Phone: 424-413-0949
  • Fax:
Mailing address:
  • Phone: 424-413-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: