Provider Demographics
NPI:1093375016
Name:SARKISSIAN, LILIT BALDJYAN (CNM)
Entity Type:Individual
Prefix:
First Name:LILIT
Middle Name:BALDJYAN
Last Name:SARKISSIAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LILIT
Other - Middle Name:
Other - Last Name:BALDJYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17007 LISETTE ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1435
Mailing Address - Country:US
Mailing Address - Phone:818-915-0982
Mailing Address - Fax:
Practice Address - Street 1:17007 LISETTE ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-1435
Practice Address - Country:US
Practice Address - Phone:818-915-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236040176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife