Healthcare Provider Details

I. General information

NPI: 1982144580
Provider Name (Legal Business Name): ARPINE VARDUMYAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9946 GAYNOR AVE
NORTH HILLS CA
91343-1605
US

IV. Provider business mailing address

9946 GAYNOR AVE
NORTH HILLS CA
91343-1605
US

V. Phone/Fax

Practice location:
  • Phone: 818-424-1728
  • Fax:
Mailing address:
  • Phone: 818-424-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number75335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: