Healthcare Provider Details

I. General information

NPI: 1528801065
Provider Name (Legal Business Name): SHARIS MICHELLE ARAKELIAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 W BROADWAY STE C
GLENDALE CA
91204-1008
US

IV. Provider business mailing address

2225 CANADA BLVD
GLENDALE CA
91208-2535
US

V. Phone/Fax

Practice location:
  • Phone: 818-664-4112
  • Fax:
Mailing address:
  • Phone: 818-482-6966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95027246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: