Provider Demographics
NPI:1114279387
Name:AVAKIAN, TAMAR ANI (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:ANI
Last Name:AVAKIAN
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:MS
Other - First Name:TAMAR
Other - Middle Name:ANI
Other - Last Name:KONYALIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP
Mailing Address - Street 1:23845 MCBEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2001
Mailing Address - Country:US
Mailing Address - Phone:661-253-8445
Mailing Address - Fax:661-253-8837
Practice Address - Street 1:23845 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-253-8445
Practice Address - Fax:661-253-8837
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily