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General NPI Number Information
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NPI Number | 1467733360
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Entity Type | Individual
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Provider Name | NERA ISMAIL ZADEH N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 4835 VAN NUYS BLVD STE 109
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2134
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Country | US
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Telephone | 818-784-3615
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Fax | 818-905-0130
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Provider Business Mailing Address
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Address Line | 2855 WASATCH CT
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3749
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Country | US
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Telephone | 818-404-2544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 598798
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 17605
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License Number State | CA
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