Provider Demographics
NPI:1457064081
Name:NERSISYAN, ESTER
Entity Type:Individual
Prefix:
First Name:ESTER
Middle Name:
Last Name:NERSISYAN
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 1:3043 GOLD CANAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6394
Mailing Address - Country:US
Mailing Address - Phone:916-858-1440
Mailing Address - Fax:916-635-1707
Practice Address - Street 1:3043 GOLD CANAL DR STE 220
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6394
Practice Address - Country:US
Practice Address - Phone:916-858-1440
Practice Address - Fax:916-635-1707
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor