Provider Demographics
NPI:1912898099
Name:NICOLE JABOURIAN LICENSED MARRIAGE AND FAMILY THERAPY, INCORPORATION
Entity type:Organization
Organization Name:NICOLE JABOURIAN LICENSED MARRIAGE AND FAMILY THERAPY, INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JABOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-495-5775
Mailing Address - Street 1:213 N GLENDALE AVE # 1035
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 E WALNUT ST STE 260
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1800
Practice Address - Country:US
Practice Address - Phone:818-495-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty