Healthcare Provider Details

I. General information

NPI: 1346473659
Provider Name (Legal Business Name): GOHAR KASPARIAN MSW TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15031 RINALDI ST
MISSION HILLS CA
91345-1207
US

IV. Provider business mailing address

516 N KAWEAH AVE
EXETER CA
93221-1200
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-8051
  • Fax: 818-496-4499
Mailing address:
  • Phone: 559-594-4969
  • Fax: 559-594-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number87328
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: