Provider Demographics
NPI:1447620182
Name:HARMANDJIAN, ALINE (DPT)
Entity type:Individual
Prefix:
First Name:ALINE
Middle Name:
Last Name:HARMANDJIAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2667 N MOORPARK RD STE 108
Mailing Address - Street 2:#108
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3001
Mailing Address - Country:US
Mailing Address - Phone:805-492-0268
Mailing Address - Fax:
Practice Address - Street 1:2667 N MOORPARK RD
Practice Address - Street 2:SUITE 108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3001
Practice Address - Country:US
Practice Address - Phone:805-492-0268
Practice Address - Fax:805-492-0274
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist