Provider Demographics
NPI:1992094643
Name:JANSZYAN-ORDUBEGIAN, NONA
Entity type:Individual
Prefix:
First Name:NONA
Middle Name:
Last Name:JANSZYAN-ORDUBEGIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NONA
Other - Middle Name:
Other - Last Name:JANSZYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3131 FOOTHILL BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4232
Mailing Address - Country:US
Mailing Address - Phone:818-300-7779
Mailing Address - Fax:818-745-0985
Practice Address - Street 1:3131 FOOTHILL BLVD STE J
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4232
Practice Address - Country:US
Practice Address - Phone:818-300-7779
Practice Address - Fax:818-745-0985
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7667OtherMEDI-CAL
CA7184OtherMEDI-CAL
CA7368OtherMEDI-CAL
CA7708OtherMEDI-CAL