Provider Demographics
NPI:1306494968
Name:ARTASHYAN, ELEN YELENA
Entity type:Individual
Prefix:MS
First Name:ELEN
Middle Name:YELENA
Last Name:ARTASHYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 W CALIFORNIA AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2234
Mailing Address - Country:US
Mailing Address - Phone:818-636-0183
Mailing Address - Fax:
Practice Address - Street 1:336 W CALIFORNIA AVE APT 203
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2234
Practice Address - Country:US
Practice Address - Phone:818-636-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program