Healthcare Provider Details

I. General information

NPI: 1831022607
Provider Name (Legal Business Name): ELEN BEREMESH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1500 S CENTRAL AVE STE 323
GLENDALE CA
91204-3858
US

IV. Provider business mailing address

1500 S CENTRAL AVE STE 323
GLENDALE CA
91204-3858
US

V. Phone/Fax

Practice location:
  • Phone: 747-200-6948
  • Fax: 747-800-8005
Mailing address:
  • Phone: 747-200-6948
  • Fax: 747-800-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: