Provider Demographics
NPI:1417563859
Name:MOVSESIAN, ROBIN ALYSSA
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ALYSSA
Last Name:MOVSESIAN
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 1:4132 KATELLA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3496
Mailing Address - Country:US
Mailing Address - Phone:562-312-1777
Mailing Address - Fax:562-318-2257
Practice Address - Street 1:4132 KATELLA AVE STE 200
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3496
Practice Address - Country:US
Practice Address - Phone:562-312-1777
Practice Address - Fax:562-318-2257
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020986363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health