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Individual

SAMUEL T GRIGORYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
29982 IVY GLENN DR STE 203, LAGUNA NIGUEL, CA 92677-2097
(949) 309-7903
(949) 716-5243
Mailing address
1437 E ESCALON AVE, FRESNO, CA 93710-5734
(559) 495-8706

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95165516
CA

Other

Enumeration date
06/22/2018
Last updated
05/15/2023
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