1942106570 NPI number — INESSA RAFAELLA HAGOPJANIAN L. AC.

Table of content: INESSA RAFAELLA HAGOPJANIAN L. AC. (NPI 1942106570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942106570 NPI number — INESSA RAFAELLA HAGOPJANIAN L. AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAGOPJANIAN
Provider First Name:
INESSA
Provider Middle Name:
RAFAELLA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L. AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942106570
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 WHITE OAK AVE UNIT 19
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENCINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91316-4513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-803-9176
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15720 VENTURA BLVD STE 613
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENCINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91436-4710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-763-2928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC20759 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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