Fimi Annie Azizian, PSY.D

Individual provider Active NPI Clinical Psychologist · Montrose, CA

NPI 1679763239 · NPPES record last updated Jul 14, 2014

Key facts

NPI
1679763239
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY24550 (CA)
Practice address
2511 Honolulu Ave
Montrose, CA 91020-1805
Phone
(818) 249-9322
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PSY24550CAMDClinical Psychologist
24550CAMDEndodontist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X PSY24550 CA Yes
Clinical Child & Adolescent Psychologist 103TC2200X PSY24550 CA
Cognitive & Behavioral Psychologist 103TB0200X PSY24550 CA
Family Psychologist 103TF0000X PSY24550 CA
Psychologist 103T00000X PSY24550 CA

Addresses

Primary practice location

2511 Honolulu Ave
Montrose, CA 91020-1805

Mailing address

2511 Honolulu Ave
Montrose, CA 91020-1805
Phone (818) 249-9322

Other providers in Montrose, CA

All providers in Montrose, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.