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NPI Code Detail

MEDICARE: LIANA GRIGORYAN AMFT

MEDICARE: LIANA GRIGORYAN AMFT
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
1101YM0800XMental Health CounselorAMFT104140CA
2106H00000XMarriage & Family TherapistAMFT104140CA

General Provider Information

NPI Number : 1912591983
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIANA GRIGORYAN AMFT
Provider Business Mailing Address
First Line : 25050 AVENUE KEARNY STE 203
Second Line :
City : VALENCIA
State : CA
Zip : 91355-1257
Country : US
Telephone Number : 818-424-9616
Fax Number :
Provider Business Practice Location Address
First Line : 25050 AVENUE KEARNY STE 203
Second Line :
City : VALENCIA
State : CA
Zip : 91355-1257
Country : US
Telephone Number : 818-424-9616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2021
Last Update Date : 03/17/2021

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