Provider Demographics
NPI:1952977423
Name:ADJEMIAN, LOUSINE (TECHNOLOGIST)
Entity type:Individual
Prefix:MS
First Name:LOUSINE
Middle Name:
Last Name:ADJEMIAN
Suffix:
Gender:F
Credentials:TECHNOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9355 CONDOR CT
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-1010
Mailing Address - Country:US
Mailing Address - Phone:818-510-1177
Mailing Address - Fax:
Practice Address - Street 1:9355 CONDOR CT
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-1010
Practice Address - Country:US
Practice Address - Phone:818-510-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHM00101505156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist