Provider Demographics
NPI:1063392918
Name:IVAN TREE THERAPY
Entity type:Organization
Organization Name:IVAN TREE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIRANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:IVANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-333-4484
Mailing Address - Street 1:10115 BEVIS AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10115 BEVIS AVE
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2801
Practice Address - Country:US
Practice Address - Phone:424-333-4484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty