Healthcare Provider Details

I. General information

NPI: 1861365322
Provider Name (Legal Business Name): NARINE KESHISHIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 LINDA ROSA AVE
PASADENA CA
91107-2310
US

IV. Provider business mailing address

433 LINDA ROSA AVE
PASADENA CA
91107-2310
US

V. Phone/Fax

Practice location:
  • Phone: 626-808-3934
  • Fax:
Mailing address:
  • Phone: 626-808-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: