Basic Information
| Provider Information | |||||||||
| NPI: | 1902280175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARUBIAN | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1327 VIENNA WAY | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902914028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013558354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1247 7TH ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904011644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152363743 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2015 | ||||||||
| LastUpdateDate: | 01/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 119282 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.