Healthcare Provider Details

I. General information

NPI: 1174999015
Provider Name (Legal Business Name): KRISTINA HAGOPIAN WHNP-BC, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD STE 525
BEVERLY HILLS CA
90211-1968
US

IV. Provider business mailing address

8920 WILSHIRE BLVD STE 515
BEVERLY HILLS CA
90211-1949
US

V. Phone/Fax

Practice location:
  • Phone: 310-657-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number95002951
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: