Healthcare Provider Details

I. General information

NPI: 1235625906
Provider Name (Legal Business Name): MONICA BABAIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 FAIR OAKS AVE STE 101
SOUTH PASADENA CA
91030-2685
US

IV. Provider business mailing address

815 E HARVARD RD
BURBANK CA
91501-1326
US

V. Phone/Fax

Practice location:
  • Phone: 626-765-4482
  • Fax:
Mailing address:
  • Phone: 323-559-9589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: