SERGE PETROSIAN


Address: 5930 S Main St, Suite 104, Los Angeles, CA 90003-1201
Phone: 8185510026

SERGE PETROSIAN (NPI# 1124391669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124391669
Entity Type Individual
Full Name SERGE PETROSIAN
Credential CADC II
Practice Address 5930 S Main St
Suite 104
Los Angeles
CA 90003-1201
Mailing Address 619 E Elmwood Ave
Apt. O
Burbank
CA 91501-2587
Practice Telephone 8185510026
Mailing Telephone 8188046520
Enumeration Date 2012-02-14
Last Update Date 2012-02-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
A7121111 CA Behavioral Health & Social Service Providers

Office Location

Street Address 5930 S MAIN ST
SUITE 104
City LOS ANGELES
State CA
Zip Code 90003-1201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124366133 Bryon D Jackson Counselor 5930 S Main St, #104, Los Angeles, CA 90003-1284 2013-01-25
1114291580 California Care Corp. Health Maintenance Organization 5930 S Main St, Ste.104, Los Angeles, CA 90003-1201 2012-03-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043831878 Didi Hirsch Psychiatric Service Community/Behavioral Health 9179 S Main Street, Los Angeles, CA 90003 2020-05-04
1780227207 Herminia E Galvez Counselor 8005 S. Figueroa Street, Business, Los Angeles, CA 90003 2019-10-28
1720567548 Banty Dental Corporation Clinic/Center 5971 S Main Street, Los Angeles, CA 90003 2018-08-13
1932623030 Mireya Melendez Case Manager/Care Coordinator 5849 Crocker Street Unit L, Los Angeles, CA 90003 2017-07-31
1356865810 Oscar Montes Jr. Social Worker 8220 San Pedro St., Los Angeles, CA 90003 2017-07-26
1619407483 Tonja Benetta Jordan Registered Nurse 5850 South Main St, Los Angeles, CA 90003 2017-06-14
1194254581 Janae Wilson Shepherd Registered Nurse 5850 S Main Street, Los Angeles, CA 90003 2017-06-08
1649709049 Eisha Eishawndra Purvis Registered Nurse 5850 S. Main Street, Los Angeles, CA 90003 2017-06-08
1689022477 Ladan Hariri Psychiatry & Neurology 1200 N.state St., Los Angeles, CA 90003 2016-06-02
1811330772 David Chavez Dental Assistant 358 East 76st, Los Angeles, CA 90003 2013-04-10
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407457377 Marian Locke Counselor 3901 W Adams Blvd, Los Angeles, CA 90018-1756 2020-11-05
1871193888 Daniel Luna Counselor 811 Beacon Ave, Los Angeles, CA 90017-2113 2020-10-28
1962000240 Frederick P Delafield Iv Counselor 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 2020-10-09
1578179941 Leo Vasquezawarez Counselor 470 E 3rd St # Ab, Los Angeles, CA 90013-1629 2020-09-21
1801401963 Manuel Gambino Counselor 11301 Wilshire Blvd Bldg 337, Los Angeles, CA 90073-1003 2020-09-14
1871107219 Frances Field Counselor 3739 Mentone Ave Apt 7, Los Angeles, CA 90034-6444 2020-09-02
1730707985 Lucia Miguel Counselor 1428 W 59th St, Los Angeles, CA 90047-1209 2020-07-13
1821615220 Sarah Payne Counselor 3217 North Eastern Ave, Los Angeles, CA 90032 2020-07-01
1376168070 Mercedes Elkoff Counselor 1745 Warnall Ave, Los Angeles, CA 90024-5358 2020-06-09
1508481201 Jeanine Ingram Counselor 3815 Lockland Dr, Los Angeles, CA 90008-3533 2020-06-09
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Competitor

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City LOS ANGELES
Zip Code 90003

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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