Provider Demographics
NPI:1538453790
Name:BOYADJIAN, SHANT (LMFT)
Entity type:Individual
Prefix:MR
First Name:SHANT
Middle Name:
Last Name:BOYADJIAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ALAMO ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2187
Mailing Address - Country:US
Mailing Address - Phone:323-459-4968
Mailing Address - Fax:
Practice Address - Street 1:3655 ALAMO ST STE 212
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063
Practice Address - Country:US
Practice Address - Phone:818-850-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist