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NPI Code Detail

MEDICARE: WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC.

MEDICARE: WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC.
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
1103TC0700XClinical Psychologist21081CA

General Provider Information

NPI Number : 1811179682
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC.
Provider Business Mailing Address
First Line : 16311 VENTURA BLVD STE 977
Second Line :
City : ENCINO
State : CA
Zip : 91436-4331
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 435 ORANGE SHOW LN STE 105
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-2015
Country : US
Telephone Number : 909-380-7740
Fax Number :
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. ZARA ASHIKYAN
Credential : PH.D.
Telephone Number : 818-907-5491
Provider Enumeration Date : 12/03/2007
Last Update Date : 12/03/2007

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Directions to “WESTERN PACIFIC PSYCHOLOGICAL NETWORK, INC. ” Practice Location

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