Provider Demographics
NPI:1962236257
Name:CHILYAN, NARINE
Entity type:Individual
Prefix:
First Name:NARINE
Middle Name:
Last Name:CHILYAN
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 1:22024 LASSEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-8335
Mailing Address - Country:US
Mailing Address - Phone:707-240-4040
Mailing Address - Fax:
Practice Address - Street 1:22024 LASSEN ST STE 100
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-8335
Practice Address - Country:US
Practice Address - Phone:707-240-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029566363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology