Healthcare Provider Details

I. General information

NPI: 1851185334
Provider Name (Legal Business Name): ANI BEDZHANYAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 N LAKE AVE STE 208
PASADENA CA
91104-2340
US

IV. Provider business mailing address

1339 N COLUMBUS AVE UNIT 123
GLENDALE CA
91202-1647
US

V. Phone/Fax

Practice location:
  • Phone: 818-559-1460
  • Fax:
Mailing address:
  • Phone: 818-590-7985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95042909
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95031684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: