Provider Demographics
NPI:1801179254
Name:MOUGHAMIAN, TALEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:TALEEN
Middle Name:
Last Name:MOUGHAMIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HOLLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1740
Mailing Address - Country:US
Mailing Address - Phone:415-338-1251
Mailing Address - Fax:
Practice Address - Street 1:1600 HOLLOWAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1740
Practice Address - Country:US
Practice Address - Phone:415-338-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002062363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health