Provider Demographics
NPI:1194522995
Name:DAVTYAN, ANGELIA NICOLE
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:NICOLE
Last Name:DAVTYAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7543 SEDGEWICK CT
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5266
Mailing Address - Country:US
Mailing Address - Phone:818-267-0479
Mailing Address - Fax:
Practice Address - Street 1:7462 N FIGUEROA ST STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1723
Practice Address - Country:US
Practice Address - Phone:800-234-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst