Individual provider Active NPI

Liana Ogannessyan

  • Marriage & Family Therapist
  • Glendale, CA
National Provider Identifier
1790535698
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT141351 Issued in CA
Practice address
308 W Wilson Ave Apt 227
Glendale, CA 91203-3682
Phone
(818) 669-1313
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT141351 CA Primary

Addresses

Primary practice location

308 W Wilson Ave Apt 227
Glendale, CA 91203-3682

Mailing address

308 W Wilson Ave Apt 227
Glendale, CA 91203-3682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260325001276 CA Practitioner - Marriage and Family Therapist 9335566850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10413 White Oak Ave
Granada Hills, CA 91344-5927

PO Box
Suite 530
Simi Valley, CA 93062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT141351CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Care Home Health CurrentSince Apr 3, 2021 Accepting new patients
Safe Space Family Therapy Inc Marriage & Family Therapist Current Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Glendale Care Home HealthGlendale, CA, CCN 757642 Home health agency 5% Or Greater Indirect Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Apr 3, 2021
Apr 3, 2021
Apr 3, 2021
Apr 3, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1790535698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W WILSON AVE APT 227",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W WILSON AVE APT 227",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033682",
            "telephone_number": "818-669-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGANNESSYAN",
        "first_name": "LIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT141351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.