Basic Information
| Provider Information | |||||||||
| NPI: | 1548416720 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALAHVERDIAN | ||||||||
| FirstName: | RONE' | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5922 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912215922 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 237 N CENTRAL AVE | ||||||||
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| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912032531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185479544 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 02/26/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC53900 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.