Provider Demographics
NPI:1831628403
Name:FAGUNDES, HELEN ZOLFAGHARI (FNP)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ZOLFAGHARI
Last Name:FAGUNDES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:ZOLFAGHARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3500
Mailing Address - Country:US
Mailing Address - Phone:424-328-2540
Mailing Address - Fax:
Practice Address - Street 1:1050 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3500
Practice Address - Country:US
Practice Address - Phone:424-328-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005331363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily