Provider Demographics
NPI:1780327791
Name:ISKANDARYAN, ROMINA (MSN, FNP)
Entity type:Individual
Prefix:
First Name:ROMINA
Middle Name:
Last Name:ISKANDARYAN
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14411 HAMLIN ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1467
Mailing Address - Country:US
Mailing Address - Phone:310-940-7171
Mailing Address - Fax:
Practice Address - Street 1:14411 HAMLIN ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1467
Practice Address - Country:US
Practice Address - Phone:818-994-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2024-05-10
Deactivation Date:2023-12-14
Deactivation Code:
Reactivation Date:2023-12-22
Provider Licenses
StateLicense IDTaxonomies
CA95268848163W00000X
CA95028386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse