Provider Demographics
NPI:1336902527
Name:ZARDKOUHI, PARISA (AGNP)
Entity type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:ZARDKOUHI
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27886 FESTIVO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-2612
Mailing Address - Country:US
Mailing Address - Phone:949-247-6788
Mailing Address - Fax:
Practice Address - Street 1:27886 FESTIVO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-2612
Practice Address - Country:US
Practice Address - Phone:949-247-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAG01240121363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology