Healthcare Provider Details

I. General information

NPI: 1255271284
Provider Name (Legal Business Name): MANIA SOPHIA ALEXANDRIAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W COLORADO ST UNIT A
GLENDALE CA
91204-1589
US

IV. Provider business mailing address

419 W COLORADO ST UNIT A
GLENDALE CA
91204-1589
US

V. Phone/Fax

Practice location:
  • Phone: 818-875-2440
  • Fax:
Mailing address:
  • Phone: 818-875-2440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95230095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: