Healthcare Provider Details

I. General information

NPI: 1275463317
Provider Name (Legal Business Name): BEAUTYLOGIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18251 ROSCOE BLVD # 201
NORTHRIDGE CA
91325-4200
US

IV. Provider business mailing address

18251 ROSCOE BLVD # 201
NORTHRIDGE CA
91325-4200
US

V. Phone/Fax

Practice location:
  • Phone: 818-336-1006
  • Fax: 747-336-3266
Mailing address:
  • Phone: 818-336-1006
  • Fax: 747-336-3266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 818-336-1006