Healthcare Provider Details

I. General information

NPI: 1194385260
Provider Name (Legal Business Name): TANYA AVOYAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MELROSE AVE
GLENDALE CA
91202-2942
US

IV. Provider business mailing address

1015 MELROSE AVE
GLENDALE CA
91202-2942
US

V. Phone/Fax

Practice location:
  • Phone: 818-859-3423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number130176
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number98274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: