1811600869 NPI number — ROWAN CENTER FOR BEHAVIORAL MEDICINE, A PSYCHOLOGICAL CORPORATION

Table of content: SHARON KAYE VANCE RD LD (NPI 1487113007)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811600869 NPI number — ROWAN CENTER FOR BEHAVIORAL MEDICINE, A PSYCHOLOGICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROWAN CENTER FOR BEHAVIORAL MEDICINE, A PSYCHOLOGICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1811600869
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 E OLIVE AVE STE 540
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91501-2132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-446-2238
Provider Business Mailing Address Fax Number:
818-284-6368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 WEST RD STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-2370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-446-2522
Provider Business Practice Location Address Fax Number:
818-284-6368
Provider Enumeration Date:
01/04/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HARTOONIAN
Authorized Official First Name:
NARINEH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, CEO
Authorized Official Telephone Number:
818-546-4339

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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