Provider Demographics
NPI:1417722786
Name:YEGOYAN, PEPPINA JOY
Entity Type:Individual
Prefix:
First Name:PEPPINA JOY
Middle Name:
Last Name:YEGOYAN
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 1:16030 VENTURA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2775
Mailing Address - Country:US
Mailing Address - Phone:747-224-2227
Mailing Address - Fax:818-471-4001
Practice Address - Street 1:16030 VENTURA BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2775
Practice Address - Country:US
Practice Address - Phone:747-224-2227
Practice Address - Fax:818-471-4001
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor