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General NPI Number Information
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NPI Number | 1568985778
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Entity Type | Organization
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Legal Business Name | NA&TJ INC
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 300 W GLENOAKS BLVD STE 105
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City | GLENDALE
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State | CA
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Zip | 91202-3084
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Country | US
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Telephone | 818-409-9917
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Fax | 818-755-3181
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Provider Business Mailing Address
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Address Line | 300 W GLENOAKS BLVD STE 105
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City | GLENDALE
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State | CA
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Zip | 91202-3084
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Country | US
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Telephone | 818-409-9917
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Fax | 818-755-3181
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Authorized Official
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Title or Position | CEO
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Name | DR. MARIAM TSATURYAN
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Credential | PSYD
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Telephone | 818-409-9917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18996
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License Number State | CA
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