Healthcare Provider Details

I. General information

NPI: 1205783578
Provider Name (Legal Business Name): FENTON CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2026
Last Update Date: 03/14/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13863 FENTON AVE
SYLMAR CA
91342-1670
US

IV. Provider business mailing address

13863 FENTON AVE
SYLMAR CA
91342-1670
US

V. Phone/Fax

Practice location:
  • Phone: 747-246-4421
  • Fax: 747-246-4425
Mailing address:
  • Phone: 747-246-4421
  • Fax: 747-246-4425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNA YAVRUYAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 424-499-7979