Healthcare Provider Details

I. General information

NPI: 1629654033
Provider Name (Legal Business Name): MERI YEVRENYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERI KHANJYAN

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 185
CONCORD CA
94520-5006
US

IV. Provider business mailing address

5850 CANOGA AVE STE 400
WOODLAND HILLS CA
91367-6554
US

V. Phone/Fax

Practice location:
  • Phone: 510-268-8120
  • Fax:
Mailing address:
  • Phone: 818-590-0386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: