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Individual

TANIA GHAZARIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17234 VALLEY BLVD, BUILDING A, FONTANA, CA 92335
(909) 427-5679
Mailing address
11234 ANDERSON STREET GME OFFICE WESTERLY SUITE C, LOMA LINDA, CA 92354

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
20A22001
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/05/2022
Last updated
04/01/2025
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