Provider Demographics
NPI:1063186740
Name:SRMABEKIAN, CHRISTINA (LVN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SRMABEKIAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 E 43RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-1255
Mailing Address - Country:US
Mailing Address - Phone:909-753-6936
Mailing Address - Fax:
Practice Address - Street 1:291 E 43RD ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-1255
Practice Address - Country:US
Practice Address - Phone:909-753-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284189164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse