Provider Demographics
NPI:1730993825
Name:KATRJIAN, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KATRJIAN
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:PO BOX 9594
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91609-1594
Mailing Address - Country:US
Mailing Address - Phone:818-642-7434
Mailing Address - Fax:
Practice Address - Street 1:2775 TAPO ST STE 102
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-0467
Practice Address - Country:US
Practice Address - Phone:818-642-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1145061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical