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Individual

LANY SIVONGSAY AVAKIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6121 N THESTA ST, #204, FRESNO, CA 93710-8603
(559) 438-7390
(559) 438-7166
Mailing address
6121 N THESTA ST, #204, FRESNO, CA 93710-8603
(559) 438-7390
(559) 438-7166

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP17618
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689849879
CA
Enumeration date
04/28/2008
Last updated
10/16/2013
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