Healthcare Provider Details

I. General information

NPI: 1396222634
Provider Name (Legal Business Name): LUCINA BABAYANTS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 S CEDAR ST
GLENDALE CA
91205-1207
US

IV. Provider business mailing address

3949 LOS FELIZ BLVD APT 510
LOS ANGELES CA
90027-2323
US

V. Phone/Fax

Practice location:
  • Phone: 818-839-4010
  • Fax: 818-839-4011
Mailing address:
  • Phone: 323-868-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number137007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: