Provider Demographics
NPI:1396507687
Name:AGOPIAN, VANA
Entity type:Individual
Prefix:
First Name:VANA
Middle Name:
Last Name:AGOPIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23055 SHERMAN WAY UNIT 4022
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91308-7003
Mailing Address - Country:US
Mailing Address - Phone:415-644-8262
Mailing Address - Fax:
Practice Address - Street 1:23055 SHERMAN WAY UNIT 4022
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91308-7003
Practice Address - Country:US
Practice Address - Phone:415-644-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1198721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical