Provider Demographics
NPI:1902355597
Name:MINASSI, LINA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:MINASSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3666
Mailing Address - Country:US
Mailing Address - Phone:747-231-0433
Mailing Address - Fax:
Practice Address - Street 1:500 E LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3666
Practice Address - Country:US
Practice Address - Phone:747-231-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist