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NPI Code Detail

MEDICARE: MRS. MELINA MINASSIAN

MEDICARE: MRS. MELINA MINASSIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1477018687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELINA MINASSIAN
Provider Business Mailing Address
First Line : 315 N ADAMS ST APT 2
Second Line :
City : GLENDALE
State : CA
Zip : 91206-5073
Country : US
Telephone Number : 818-825-4594
Fax Number :
Provider Business Practice Location Address
First Line : 21600 OXNARD ST STE 1030
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-5085
Country : US
Telephone Number : 877-206-1009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2019
Last Update Date : 02/01/2019

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