Provider Demographics
NPI:1699522102
Name:OGANYAN, SEDA LYNETTE (FNP)
Entity type:Individual
Prefix:
First Name:SEDA
Middle Name:LYNETTE
Last Name:OGANYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N BRAND BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2583
Mailing Address - Country:US
Mailing Address - Phone:818-247-9717
Mailing Address - Fax:818-247-9760
Practice Address - Street 1:1141 N BRAND BLVD STE 400
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2583
Practice Address - Country:US
Practice Address - Phone:818-247-9717
Practice Address - Fax:818-247-9760
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95228582363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care