# ACTIVIA PHYSICAL THERAPY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255168357
- **Authorized official:** LAURA AGHAJANYAN (CEO)
- **Authorized official phone:** (818) 458-1500

## Contact information

- **Practice address:** 10324 BALBOA BLVD STE 101, GRANADA HILLS, CA 91344-7349
- **Practice address phone:** (424) 344-4474
- **Practice address fax:** (818) 279-2804
- **Mailing address:** 10324 BALBOA BLVD STE 101, GRANADA HILLS, CA 91344-7349
- **Mailing address phone:** (424) 344-4474
- **Mailing address fax:** (818) 279-2804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 09/14/2024
- **Last updated:** 09/16/2024