Provider Demographics
NPI:1598971061
Name:AZADIAN, NANCY (PHD LAC DNBAO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:AZADIAN
Suffix:
Gender:F
Credentials:PHD LAC DNBAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 E 17TH ST STE N460
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2265
Mailing Address - Country:US
Mailing Address - Phone:714-835-9147
Mailing Address - Fax:714-835-2947
Practice Address - Street 1:1125 E 17TH ST STE N460
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2265
Practice Address - Country:US
Practice Address - Phone:714-835-9147
Practice Address - Fax:714-835-2947
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6476171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist