| Dergregorian Psychological, Apc | |
|
231 E Burbank Blvd Apt 102 Burbank CA 91502-1044 | |
| (626) 460-0327 | |
| Not Available |
| Full Name | Dergregorian Psychological, Apc |
|---|---|
| Speciality | Psychologist |
| Location | 231 E Burbank Blvd Apt 102, Burbank, California |
| Authorized Official Name and Position | Jennifer Dergregorian (CEO) |
| Authorized Official Contact | 7143286307 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dergregorian Psychological, Apc 231 E Burbank Blvd Apt 102 Burbank CA 91502-1044 Ph: (626) 460-0327 | Dergregorian Psychological, Apc 231 E Burbank Blvd Apt 102 Burbank CA 91502-1044 Ph: (626) 460-0327 |
| NPI Number | 1922744101 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 2365821980 |
|---|---|
| Medicare Enrollment ID | O20220628000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922744101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Dergregorian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952650038 PECOS PAC ID: 3375867955 Enrollment ID: I20150131000062 |
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