Healthcare Provider Details

I. General information

NPI: 1770468563
Provider Name (Legal Business Name): SADAT MIRMOJARABIAN FNP MSN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2025
Last Update Date: 08/09/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 SPRINGFORD DR
SUN VALLEY CA
91352-3649
US

IV. Provider business mailing address

8401 SPRINGFORD DR
SUN VALLEY CA
91352-3649
US

V. Phone/Fax

Practice location:
  • Phone: 747-221-2986
  • Fax:
Mailing address:
  • Phone: 747-221-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: