Provider Demographics
NPI:1790553675
Name:YEGHYAIAN, ANAIS (NP)
Entity Type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:YEGHYAIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E CHEVY CHASE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4199
Mailing Address - Country:US
Mailing Address - Phone:818-827-3898
Mailing Address - Fax:818-827-3897
Practice Address - Street 1:1500 E CHEVY CHASE DR STE 204
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4199
Practice Address - Country:US
Practice Address - Phone:818-827-3898
Practice Address - Fax:818-827-3897
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027245363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care