Provider Demographics
NPI:1548364011
Name:SAHAKIAN, NORA I (PH D)
Entity type:Individual
Prefix:DR
First Name:NORA
Middle Name:I
Last Name:SAHAKIAN
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:DR
Other - First Name:NORA
Other - Middle Name:SOUREN
Other - Last Name:ISRAELIAN-KASPARIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PH D
Mailing Address - Street 1:1312 EL HITO CIR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2336
Mailing Address - Country:US
Mailing Address - Phone:818-240-1065
Mailing Address - Fax:818-240-1065
Practice Address - Street 1:100 N BRAND BLVD
Practice Address - Street 2:STE 210
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2641
Practice Address - Country:US
Practice Address - Phone:818-240-1065
Practice Address - Fax:818-240-1065
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16606103TC0700X, 103TH0100X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP16606Medicare PIN
P19564Medicare UPIN