Individual provider Active NPI

Loida Mansourian, NP

  • Adult Health Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1104760677
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP95039051 Issued in CA
Practice address
409 W Glenoaks Blvd
Glendale, CA 91202-2916
Phone
(818) 240-4300
NPI assigned
Apr 16, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X NP95039051 CA Primary

Addresses

Primary practice location

409 W Glenoaks Blvd
Glendale, CA 91202-2916

Mailing address

6348 N Milwaukee Ave Ste 390
Chicago, IL 60646-3728
Phone (847) 235-6130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260504006353 CA Practitioner - Nurse Practitioner 6800364340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Karefirst Nursing California PCGroup PAC ID 2264908326, 10 clinicians

Practice addresses (Care Compare)

5522 Gracewood Ave
Arcadia, CA 91007-8409
Phone (847) 235-6130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95039051CAMDAdult Health Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1104760677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6348 N MILWAUKEE AVE STE 390",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606463728",
            "telephone_number": "847-235-6130",
            "fax_number": "847-235-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022916",
            "telephone_number": "818-240-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURIAN",
        "first_name": "LOIDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP95039051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.