Healthcare Provider Details

I. General information

NPI: 1427918259
Provider Name (Legal Business Name): LIGHTPATH BEHAVIORAL SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7543 SUMMITROSE ST
TUJUNGA CA
91042-1932
US

IV. Provider business mailing address

7543 SUMMITROSE ST
TUJUNGA CA
91042-1932
US

V. Phone/Fax

Practice location:
  • Phone: 818-577-0358
  • Fax:
Mailing address:
  • Phone: 818-804-5544
  • Fax: 209-292-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL MATINYAN
Title or Position: DIRECTOR
Credential:
Phone: 818-818-2180