Individual
MARAL VAHE DERKHORENIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 974-0770
Mailing address
1534 MORADA PL, ALTADENA, CA 91001-3232
(818) 442-8489
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
638416
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95004328
CA
Other
Enumeration date
08/10/2016
Last updated
06/16/2022
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