Healthcare Provider Details

I. General information

NPI: 1255603965
Provider Name (Legal Business Name): L.A. PSYCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11846 VENTURA BLVD STE 204
STUDIO CITY CA
91604-2620
US

IV. Provider business mailing address

11846 VENTURA BLVD STE 204
STUDIO CITY CA
91604-2620
US

V. Phone/Fax

Practice location:
  • Phone: 818-523-9394
  • Fax: 818-286-9570
Mailing address:
  • Phone: 818-523-9394
  • Fax: 818-286-9570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 21883
License Number StateCA

VIII. Authorized Official

Name: DR. SHEYDA MIA MELKONIAN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 818-523-9394