Provider Demographics
NPI:1225615255
Name:HAJYAN, SUSANNA
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:HAJYAN
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 1:12509 OXNARD ST STE 215
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4443
Mailing Address - Country:US
Mailing Address - Phone:747-285-2124
Mailing Address - Fax:747-285-2125
Practice Address - Street 1:12509 OXNARD ST STE 215
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4443
Practice Address - Country:US
Practice Address - Phone:747-285-2124
Practice Address - Fax:747-285-2125
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health