Healthcare Provider Details

I. General information

NPI: 1851198840
Provider Name (Legal Business Name): MARIA LIANA HURMETIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 DORAL AVE
NORTHRIDGE CA
91326-1438
US

IV. Provider business mailing address

11900 DORAL AVE
NORTHRIDGE CA
91326-1438
US

V. Phone/Fax

Practice location:
  • Phone: 818-334-9951
  • Fax:
Mailing address:
  • Phone: 818-334-9951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: