Healthcare Provider Details

I. General information

NPI: 1679402531
Provider Name (Legal Business Name): LONA AMIRKHANIAN MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 5TH ST
GLENDALE CA
91201-4820
US

IV. Provider business mailing address

1405 5TH ST
GLENDALE CA
91201-4820
US

V. Phone/Fax

Practice location:
  • Phone: 818-588-8024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number711182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: