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General NPI Number Information
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NPI Number | 1811016942
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Entity Type | Individual
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Provider Name | TINA ALEXANDRIAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 100 N BRAND BLVD STE 516
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City | GLENDALE
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State | CA
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Zip | 91203-2614
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Country | US
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Telephone | 818-281-8210
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1595
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City | LA CANADA
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State | CA
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Zip | 91012
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Country | US
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Telephone | 818-281-8210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY24103
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License Number State | CA
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