Healthcare Provider Details

I. General information

NPI: 1083433312
Provider Name (Legal Business Name): VANOWEN ADHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 02/01/2026
Certification Date: 02/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 HAZELTINE AVE
VAN NUYS CA
91405-4761
US

IV. Provider business mailing address

6750 HAZELTINE AVE
VAN NUYS CA
91405-4761
US

V. Phone/Fax

Practice location:
  • Phone: 707-788-8070
  • Fax:
Mailing address:
  • Phone: 707-788-8070
  • Fax: 707-788-8078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HASMIK SAHAKYAN
Title or Position: CONSULTANT
Credential:
Phone: 818-731-4021