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NPI Code Detail

MEDICARE: MRS. AYDA MINASYAN

MEDICARE: MRS. AYDA MINASYAN
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
1103K00000XBehavior Analyst6743TX
2103K00000XBehavior Analyst1-20-46845CA

General Provider Information

NPI Number : 1790163392
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AYDA MINASYAN
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 16360 ROSCOE BLVD STE 100
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-1206
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2015
Last Update Date : 03/22/2024

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Directions to “ MRS. AYDA MINASYAN ” Practice Location

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