Provider Demographics
NPI:1669211298
Name:YEPISKOPSYAN, ERIC (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:YEPISKOPSYAN
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W LEXINGTON DR STE 206D
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2230
Mailing Address - Country:US
Mailing Address - Phone:323-553-0836
Mailing Address - Fax:818-301-2548
Practice Address - Street 1:121 W LEXINGTON DR STE 206D
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2230
Practice Address - Country:US
Practice Address - Phone:323-553-0836
Practice Address - Fax:818-301-2548
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95211829163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health