Healthcare Provider Details

I. General information

NPI: 1942911441
Provider Name (Legal Business Name): YEPRAKSIA AGAZARYAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONGRESS ST STE 155
PASADENA CA
91105-3027
US

IV. Provider business mailing address

10 CONGRESS ST STE 155
PASADENA CA
91105-3027
US

V. Phone/Fax

Practice location:
  • Phone: 626-486-0181
  • Fax:
Mailing address:
  • Phone: 626-486-0181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5018694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: