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General NPI Number Information
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NPI Number | 1740184027
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Entity Type | Organization
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Legal Business Name | RA PROFESSIONAL NURSING CORP
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 7930 WENTWORTH ST
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City | SUNLAND
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State | CA
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Zip | 91040-2222
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Country | US
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Telephone | 818-268-7163
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Fax |
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Provider Business Mailing Address
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Address Line | 7930 WENTWORTH ST
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City | SUNLAND
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State | CA
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Zip | 91040-2222
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Country | US
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Telephone | 818-268-7163
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MR. ROMAN AYVAZIAN
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Credential | BSN-RN
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Telephone | 818-268-7163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NULL
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