Healthcare Provider Details

I. General information

NPI: 1073937900
Provider Name (Legal Business Name): MARAL H. SABOUNJIAN-SARKISSIAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 GREENBRIAR RD
GLENDALE CA
91207-1253
US

IV. Provider business mailing address

1329 GREENBRIAR RD
GLENDALE CA
91207-1253
US

V. Phone/Fax

Practice location:
  • Phone: 818-606-8825
  • Fax:
Mailing address:
  • Phone: 818-606-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number529187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: