Provider Demographics
NPI:1770148058
Name:NAZARPOOR, STELLA (MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:NAZARPOOR
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15621 ODYSSEY DR
Mailing Address - Street 2:UNIT 37
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3282
Mailing Address - Country:US
Mailing Address - Phone:818-404-4230
Mailing Address - Fax:
Practice Address - Street 1:800 S VICTORY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2489
Practice Address - Country:US
Practice Address - Phone:818-860-0133
Practice Address - Fax:818-860-0134
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010942363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health