Healthcare Provider Details

I. General information

NPI: 1164480430
Provider Name (Legal Business Name): ROSANNA OHANJANIAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ROUZANNA, RUZANNA OHANJANIAN

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 GRANT RD
MOUNTAIN VIEW CA
94040-3250
US

IV. Provider business mailing address

1189 CAPRI DR
CAMPBELL CA
95008-6061
US

V. Phone/Fax

Practice location:
  • Phone: 650-941-7101
  • Fax: 801-705-1948
Mailing address:
  • Phone: 650-888-8907
  • Fax: 801-705-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY16240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: