MEDICARE: ANI KAVUKCHYAN

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	106H00000X	Marriage & Family Therapist	160181	CA

General Provider Information

NPI Number	:	1588353908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANI KAVUKCHYAN

Provider Business Mailing Address
First Line	:	17434 MAYFLOWER DR
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-2222
Country	:	US
Telephone Number	:	818-267-9043
Fax Number	:

Provider Business Practice Location Address
First Line	:	23504 LYONS AVE STE 401B
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91321-5777
Country	:	US
Telephone Number	:	661-977-4747
Fax Number	:

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

Provider Enumeration Date	:	05/02/2023
Last Update Date	:	01/14/2026

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Directions to “ ANI KAVUKCHYAN ” Practice Location

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