MEDICARE: SOFI MASTEYAN LCSW

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	1041C0700X	Clinical Social Worker	102956	CA

General Provider Information

NPI Number	:	1801665922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFI MASTEYAN LCSW

Provider Business Mailing Address
First Line	:	6616 ETHEL AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 S CHEVY CHASE DR STE 205
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-4435
Country	:	US
Telephone Number	:	818-844-4298
Fax Number	:

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

Provider Enumeration Date	:	12/29/2023
Last Update Date	:	12/06/2025

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Directions to “ SOFI MASTEYAN LCSW” Practice Location

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