MEDICARE: MARIANNA TERZIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA59056	CA
2	363A00000X	Physician Assistant	PA1687	NV

General Provider Information

NPI Number	:	1982060836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNA TERZIAN

Provider Business Mailing Address
First Line	:	17114 DEVONSHIRE ST # 200
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-1619
Country	:	US
Telephone Number	:	818-843-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	11500 BURBANK BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2308
Country	:	US
Telephone Number	:	818-599-9971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2016
Last Update Date	:	02/11/2026

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Directions to “ MARIANNA TERZIAN ” Practice Location

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