Provider Demographics
NPI:1356606420
Name:SARCHISIAN, ANDREEA ARAXI (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ANDREEA
Middle Name:ARAXI
Last Name:SARCHISIAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 N MARIPOSA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1415
Mailing Address - Country:US
Mailing Address - Phone:323-860-6660
Mailing Address - Fax:
Practice Address - Street 1:1257 N MARIPOSA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1415
Practice Address - Country:US
Practice Address - Phone:323-860-6660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10126235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist