Provider Demographics
NPI:1356068878
Name:OVSEPYAN, VAHE (NP)
Entity type:Individual
Prefix:MR
First Name:VAHE
Middle Name:
Last Name:OVSEPYAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1440
Mailing Address - Country:US
Mailing Address - Phone:818-644-0502
Mailing Address - Fax:
Practice Address - Street 1:13619 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-5002
Practice Address - Country:US
Practice Address - Phone:818-290-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022468207RH0002X, 363LA2100X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)