Provider Demographics
NPI:1922347731
Name:ALEXANDARIAN, SANAN (MSC, CCC-SLP#21273)
Entity type:Individual
Prefix:
First Name:SANAN
Middle Name:
Last Name:ALEXANDARIAN
Suffix:
Gender:F
Credentials:MSC, CCC-SLP#21273
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W SIERRA MADRE BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2370
Mailing Address - Country:US
Mailing Address - Phone:818-640-4883
Mailing Address - Fax:
Practice Address - Street 1:960 E GREEN ST STE L-02
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-677-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA21273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program