Provider Demographics
NPI:1578242129
Name:TONOYAN, ROZA
Entity Type:Individual
Prefix:
First Name:ROZA
Middle Name:
Last Name:TONOYAN
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 1:8315 OSO AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1351
Mailing Address - Country:US
Mailing Address - Phone:747-206-5192
Mailing Address - Fax:747-202-3787
Practice Address - Street 1:8315 OSO AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-1351
Practice Address - Country:US
Practice Address - Phone:747-206-5192
Practice Address - Fax:747-202-3787
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197610314310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility