Provider Demographics
NPI:1275990699
Name:ORELLANA, TARYN (NP)
Entity Type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:150 E OLIVE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1849
Mailing Address - Country:US
Mailing Address - Phone:818-973-4899
Mailing Address - Fax:
Practice Address - Street 1:150 E OLIVE AVE STE 203
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1849
Practice Address - Country:US
Practice Address - Phone:818-973-4899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-16
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA827062163W00000X
CA95006039363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse