MEDICARE: ROSE GORLEKIAN

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	155323	CA

General Provider Information

NPI Number	:	1770476467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE GORLEKIAN

Provider Business Mailing Address
First Line	:	1634 RIVERSIDE DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2911
Country	:	US
Telephone Number	:	323-907-7888
Fax Number	:

Provider Business Practice Location Address
First Line	:	1634 RIVERSIDE DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2911
Country	:	US
Telephone Number	:	323-907-7888
Fax Number	:

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

Provider Enumeration Date	:	05/31/2025
Last Update Date	:	05/31/2025

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Directions to “ ROSE GORLEKIAN ” Practice Location

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