Provider Demographics
NPI:1215130570
Name:KASSABIAN, KAREN R (APN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:KASSABIAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E CHAPMAN AVE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2237
Mailing Address - Country:US
Mailing Address - Phone:714-516-9045
Mailing Address - Fax:
Practice Address - Street 1:1215 E CHAPMAN AVE
Practice Address - Street 2:SUITE #6
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2237
Practice Address - Country:US
Practice Address - Phone:714-516-9045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00134600363LA2200X
CA18957363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health