Healthcare Provider Details

I. General information

NPI: 1376185090
Provider Name (Legal Business Name): LUSINE AZATIAN PMH-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 E PALMDALE BLVD STE J
PALMDALE CA
93550-4952
US

IV. Provider business mailing address

11204 PASO ROBLES AVE
GRANADA HILLS CA
91344-4150
US

V. Phone/Fax

Practice location:
  • Phone: 661-575-1800
  • Fax:
Mailing address:
  • Phone: 818-813-4241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95010943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: