MEDICARE: DR. LUSINE GABRIELYAN PSY.D.

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
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1528352994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUSINE GABRIELYAN PSY.D.

Provider Business Mailing Address
First Line	:	21600 OXNARD ST STE 200
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-4971
Country	:	US
Telephone Number	:	818-298-1128
Fax Number	:

Provider Business Practice Location Address
First Line	:	21600 OXNARD ST STE 1030
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-4976
Country	:	US
Telephone Number	:	818-298-1128
Fax Number	:	818-457-4617

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	07/23/2024

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