Healthcare Provider Details

I. General information

NPI: 1386438000
Provider Name (Legal Business Name): SUSAN KARSYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6944 BELLAIRE AVE
NORTH HOLLYWOOD CA
91605-5223
US

IV. Provider business mailing address

6944 BELLAIRE AVE
NORTH HOLLYWOOD CA
91605-5223
US

V. Phone/Fax

Practice location:
  • Phone: 818-292-2229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040298
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95303740
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number95303740
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number95303740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: