Provider Demographics
NPI:1700374352
Name:PAGHASIAN, EMERENCIANA (COMMUNITY HEALTH RN)
Entity Type:Individual
Prefix:
First Name:EMERENCIANA
Middle Name:
Last Name:PAGHASIAN
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 SCHILLING PL FL 1
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4527
Mailing Address - Country:US
Mailing Address - Phone:831-796-1387
Mailing Address - Fax:831-796-8690
Practice Address - Street 1:1441 SCHILLING PL FL 1
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4527
Practice Address - Country:US
Practice Address - Phone:831-796-1387
Practice Address - Fax:831-796-8690
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502218163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA502218Medicaid