Healthcare Provider Details

I. General information

NPI: 1265379440
Provider Name (Legal Business Name): ANI TOVMASIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 CLOUD AVE
LA CRESCENTA CA
91214-3440
US

IV. Provider business mailing address

223 N JACKSON ST
GLENDALE CA
91206-4380
US

V. Phone/Fax

Practice location:
  • Phone: 818-236-3692
  • Fax:
Mailing address:
  • Phone: 818-241-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: