Provider Demographics
NPI:1265041511
Name:HAMZEH, ELHAM (NP)
Entity Type:Individual
Prefix:
First Name:ELHAM
Middle Name:
Last Name:HAMZEH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6928 OWENSMOUTH AVE # 105
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2095
Mailing Address - Country:US
Mailing Address - Phone:925-890-3621
Mailing Address - Fax:866-458-0651
Practice Address - Street 1:6928 OWENSMOUTH AVE # 105
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2095
Practice Address - Country:US
Practice Address - Phone:818-446-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95017649363LP0808X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program