Provider Demographics
NPI:1386811909
Name:GORGORIAN, ALINA (MA, MSED)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:GORGORIAN
Suffix:
Gender:F
Credentials:MA, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18607 DAISY PL
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2130
Mailing Address - Country:US
Mailing Address - Phone:917-353-5331
Mailing Address - Fax:
Practice Address - Street 1:1000 WEST CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90509
Practice Address - Country:US
Practice Address - Phone:310-222-3198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling