Basic Information
| Provider Information | |||||||||
| NPI: | 1649663113 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALFAYAN | ||||||||
| FirstName: | TAMAR | ||||||||
| MiddleName: | ARLINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5208 NEW YORK AVE | ||||||||
| Address2: | |||||||||
| City: | LA CRESCENTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912141154 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 237 N CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912032531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185479544 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2015 | ||||||||
| LastUpdateDate: | 11/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.