Healthcare Provider Details

I. General information

NPI: 1023920576
Provider Name (Legal Business Name): AREVIK BAGDASARIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ROSEVILLE PKWY APT 3313
ROSEVILLE CA
95747-4171
US

IV. Provider business mailing address

350 ROSEVILLE PKWY APT 3313
ROSEVILLE CA
95747-4171
US

V. Phone/Fax

Practice location:
  • Phone: 305-761-7105
  • Fax:
Mailing address:
  • Phone: 305-761-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: