Active NPI
Tsoline Konialian, PSY D
- Clinical Psychologist
- Rosemead, CA
National Provider Identifier
1053361600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY19955
- Practice address
- 4519 Rosemead Blvd FL 2
Rosemead, CA 91770 - Phone
- (626) 524-2807
- Fax
- (626) 359-6535
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY19955 | CA | Primary |
Addresses
Primary practice location
4519 Rosemead Blvd FL 2
Rosemead, CA 91770
Mailing address
750 Terrado Plaza, Ste 40
Physicians Billing & Consuling Service
Covina, CA 91723
Phone (626) 524-2807
Other names 1
- Dr. Tsoline Matossian
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY19955 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1053361600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 TERRADO PLAZA, STE 40",
"address_2": "PHYSICIANS BILLING & CONSULING SERVICE",
"city": "COVINA",
"state": "CA",
"postal_code": "91723",
"telephone_number": "626-524-2807",
"fax_number": "626-359-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4519 ROSEMEAD BLVD FL 2",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "91770",
"telephone_number": "626-524-2807",
"fax_number": "626-359-6535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONIALIAN",
"first_name": "TSOLINE",
"name_prefix": "Dr.",
"credential": "PSY D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY19955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TSOLINE",
"last_name": "MATOSSIAN",
"prefix": "DR.",
"credential": "PSY D",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.