Provider Demographics
NPI:1619843372
Name:GASPARIAN, MARINE MARY (MSN-AGACNP)
Entity type:Individual
Prefix:
First Name:MARINE
Middle Name:MARY
Last Name:GASPARIAN
Suffix:
Gender:F
Credentials:MSN-AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9143 VALJEAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3817
Mailing Address - Country:US
Mailing Address - Phone:818-272-4043
Mailing Address - Fax:
Practice Address - Street 1:9143 VALJEAN AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3817
Practice Address - Country:US
Practice Address - Phone:818-272-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025427363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care