EXTRAORDINARY YOU/DR. AGNES OH (NPI# 1649748450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649748450 |
| Entity Type | Organization |
| Organization Name | EXTRAORDINARY YOU/DR. AGNES OH |
| Other Organization Name | DR. AGNES OH |
| Practice Address |
1010 N Central Ave # 315 Glendale CA 91202-2937 |
| Practice Telephone | 8182451129 |
| Mailing Telephone | 8182451129 |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-12-19 |
| Authorized Official Name | DR. AGNES OH (OWNER) |
| Authorized Official Telephone | 8184411096 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Dr. Agnes Oh | Doing Business As Name - Organization |
| Street Address |
1010 N CENTRAL AVE # 315 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91202-2937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063531523 | Un Chu Agnes Oh | Psychologist | 1010 N Central Ave # 315, Glendale, CA 91202 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538857 | Forever Active Cbas | Clinic/Center | 1111 W Glenoaks Blvd, Glendale, CA 91202 | 2018-11-29 |
| 1144724436 | Kristine Bustos | Nurse Practitioner | 1200 N Pacific Ave Ste 104, Glendale, CA 91202 | 2018-03-21 |
| 1295159614 | Kevin Lew | Dentist | 1122 N. Brand Blvd. Suite 102, Glendale, CA 91202 | 2014-02-05 |
| 1568709350 | Helen Chalakians | Counselor | 525 Glenwood Rd, Glendale, CA 91202 | 2013-01-14 |
| 1316216161 | Teresa Eligio | Nurse Practitioner | 857 Grant Ave, Glendale, CA 91202 | 2011-12-23 |
| 1033486139 | Advance Hospice Care, Inc. | Home Health | 1209 N. Central Ave Suite 204, Glendale, CA 91202 | 2011-11-18 |
| 1659518785 | Sarine Davityan | Marriage & Family Therapist | 1010 N Central Ave # 310, Glendale, CA 91202 | 2009-01-12 |
| 1760635619 | Tatiana Mikaelian Dds Inc | Dentist | 1209 N. Central Ave, #203, Glendale, CA 91202 | 2008-10-23 |
| 1669624219 | Marine Demirjian | Allergy & Immunology | 1131 N Pacific Ave, Glendale, CA 91202 | 2008-10-15 |
| 1902055783 | Lousine Vahagn Kirakosian | Dentist | 125 E. Glenoaks Blvd., Suite 103, Glendale, CA 91202 | 2008-09-16 |
| Find all providers in zip 91202 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537709 | Kendra Nicole Rosenfeld | Counselor | 10218 N 60th Ln, Glendale, AZ 85302-1256 | 2020-10-26 |
| 1609483825 | Wisemind Sober Living and Treatment, LLC | Counselor | 5755 W Irma Ln, Glendale, AZ 85308-9178 | 2020-09-30 |
| 1740814664 | Maryjoy C Kearns | Counselor | 7400 W Arrowhead Clubhouse Dr Apt 2036, Glendale, AZ 85308-8825 | 2020-02-29 |
| 1366089997 | Lilit Ginosyan Hayrapetyan | Counselor | 401 N Brand Blvd Ste 366, Glendale, CA 91203-4427 | 2019-12-02 |
| 1104473552 | Sabrina Laporta | Counselor | 7037 65th Pl Apt 1r, Glendale, NY 11385-6426 | 2019-08-21 |
| 1760042667 | Arineh Ohanian | Counselor | 1022 Elm Ave, Glendale, CA 91201-3424 | 2019-06-13 |
| 1467010801 | Rebecca Bautista | Counselor | 223 North Jackson Street, Glendale, CA 91206 | 2019-05-31 |
| 1093275018 | Heather Marie Ford | Counselor | 7303 W Robin Ln, Glendale, AZ 85310-5653 | 2019-03-25 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1992209431 | Jessica Ann Van Leer | Counselor | 17505 N 79th Ave Ste 410, Glendale, AZ 85308-8732 | 2018-03-20 |
| Find all providers in GLENDALE | ||||
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| 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.