Provider Demographics
NPI:1053361600
Name:KONIALIAN, TSOLINE (PSY D)
Entity type:Individual
Prefix:DR
First Name:TSOLINE
Middle Name:
Last Name:KONIALIAN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:TSOLINE
Other - Middle Name:
Other - Last Name:MATOSSIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSY D
Mailing Address - Street 1:750 TERRADO PLAZA, STE 40
Mailing Address - Street 2:PHYSICIANS BILLING & CONSULING SERVICE
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723
Mailing Address - Country:US
Mailing Address - Phone:626-524-2807
Mailing Address - Fax:626-359-6565
Practice Address - Street 1:4519 ROSEMEAD BLVD FL 2
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770
Practice Address - Country:US
Practice Address - Phone:626-524-2807
Practice Address - Fax:626-359-6535
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19955103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q37767Medicare ID - Type Unspecified
CP19955Medicare ID - Type Unspecified