Basic Information
| Provider Information | |||||||||
| NPI: | 1184145120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAKOBIAN | ||||||||
| FirstName: | DANA | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17046 BURBANK BLVD APT 8 | ||||||||
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| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913161876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189034477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 38600 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935514483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613825000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2017 | ||||||||
| LastUpdateDate: | 06/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 514519 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.