Healthcare Provider Details

I. General information

NPI: 1427209139
Provider Name (Legal Business Name): CHRISTINE CHAKARIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10605 BALBOA BLVD STE 100
GRANADA HILLS CA
91344-6367
US

IV. Provider business mailing address

919 1ST ST
SAN FERNANDO CA
91340-2957
US

V. Phone/Fax

Practice location:
  • Phone: 818-832-2400
  • Fax:
Mailing address:
  • Phone: 818-256-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW66242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: