Healthcare Provider Details

I. General information

NPI: 1477477198
Provider Name (Legal Business Name): NESTOR ARDIANO MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17247 BIRCHER ST
GRANADA HILLS CA
91344-2410
US

IV. Provider business mailing address

17247 BIRCHER ST
GRANADA HILLS CA
91344-2410
US

V. Phone/Fax

Practice location:
  • Phone: 310-628-4191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: