Healthcare Provider Details

I. General information

NPI: 1750217485
Provider Name (Legal Business Name): CHRISTINA CARA VARTAN-AGHADJANIAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 VENTURA BLVD # 851
STUDIO CITY CA
91604-2406
US

IV. Provider business mailing address

12400 VENTURA BLVD # 851
STUDIO CITY CA
91604-2406
US

V. Phone/Fax

Practice location:
  • Phone: 323-459-5062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number147573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: