Provider Demographics
NPI:1740478171
Name:NOURANIAN, HOMA SAHAFI (RN)
Entity type:Individual
Prefix:
First Name:HOMA
Middle Name:SAHAFI
Last Name:NOURANIAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26972 EL RETIRO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3408
Mailing Address - Country:US
Mailing Address - Phone:949-874-4472
Mailing Address - Fax:
Practice Address - Street 1:26972 EL RETIRO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3408
Practice Address - Country:US
Practice Address - Phone:949-874-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA694639163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse