Healthcare Provider Details

I. General information

NPI: 1386811909
Provider Name (Legal Business Name): ALINA GORGORIAN M.A., M.S.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WEST CARSON ST
TORRANCE CA
90509
US

IV. Provider business mailing address

18607 DAISY PL
NORTHRIDGE CA
91326-2130
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3198
  • Fax:
Mailing address:
  • Phone: 917-353-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: