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General NPI Number Information
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NPI Number | 1801683784
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Entity Type | Individual
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Provider Name | ELIZA SHAKHIKYAN FNP
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 16260 VENTURA BLVD STE LL15
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City | ENCINO
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State | CA
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Zip | 91436-4931
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Country | US
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Telephone | 818-905-1567
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Fax |
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Provider Business Mailing Address
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Address Line | 13443 STAGG ST
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City | PANORAMA CITY
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State | CA
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Zip | 91402-6429
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Country | US
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Telephone | 213-377-5000
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034788
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License Number State | CA
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