1417089665 NPI number — VICKEN KABAKIAN LMFT

Table of content: MS. AMY L. TUTTLE LMP, LMT (NPI 1013117761)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417089665 NPI number — VICKEN KABAKIAN LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KABAKIAN
Provider First Name:
VICKEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417089665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15339 SATICOY ST
Provider Second Line Business Mailing Address:
C/O THE HELP GROUP
Provider Business Mailing Address City Name:
VAN NUYS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91406-3345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-389-3900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15339 SATICOY ST
Provider Second Line Business Practice Location Address:
C/O THE HELP GROUP
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91406-3345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-389-3900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 41453 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)