Provider Demographics
NPI:1245927193
Name:KALANJIAN, ANAITA
Entity type:Individual
Prefix:
First Name:ANAITA
Middle Name:
Last Name:KALANJIAN
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 1:1901 E TULARE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-1513
Mailing Address - Country:US
Mailing Address - Phone:559-736-6881
Mailing Address - Fax:888-355-9911
Practice Address - Street 1:1901 E TULARE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-1513
Practice Address - Country:US
Practice Address - Phone:559-736-6881
Practice Address - Fax:888-355-9911
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2023-0000507261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care