Healthcare Provider Details

I. General information

NPI: 1366334468
Provider Name (Legal Business Name): NORA HOVHANNISYAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18713 STONEHAVEN CT
PORTER RANCH CA
91326-1528
US

IV. Provider business mailing address

18713 STONEHAVEN CT
PORTER RANCH CA
91326-1528
US

V. Phone/Fax

Practice location:
  • Phone: 818-730-0337
  • Fax: 818-514-1454
Mailing address:
  • Phone: 818-730-0337
  • Fax: 818-514-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95114992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: