Healthcare Provider Details

I. General information

NPI: 1467008805
Provider Name (Legal Business Name): NAIRY ZICHELLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAIRY AINTABLIAN LCSW

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 LAS TUNAS DR.
TEMPLE CITY CA
91780
US

IV. Provider business mailing address

PO BOX 2816 HONOLULU AVE
VERDUGO CITY CA
91046-1001
US

V. Phone/Fax

Practice location:
  • Phone: 626-548-5000
  • Fax: 626-737-6034
Mailing address:
  • Phone: 626-701-4249
  • Fax: 626-737-6034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW87087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: