Provider Demographics
NPI:1962153429
Name:TERJANYAN PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:TERJANYAN PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERJANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, FNP-BC
Authorized Official - Phone:818-426-3553
Mailing Address - Street 1:12400 VENTURA BLVD # 696
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2406
Mailing Address - Country:US
Mailing Address - Phone:818-426-3553
Mailing Address - Fax:
Practice Address - Street 1:1300 N VERMONT AVE STE 902
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6094
Practice Address - Country:US
Practice Address - Phone:323-913-9130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center