Individual provider Active NPI

Tagui Tina Damlakyan, FNP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1235940545
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9502841 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 409-8000
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9502841 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

636 E Verdugo Ave Apt M
Burbank, CA 91501-3112
Phone (818) 480-2325

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
I20251031000781 CA Practitioner - Nurse Practitioner 4880183599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1311 N San Fernando Blvd
Burbank, CA 91504-4236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9502841CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All-Inclusive Community Health Center Current Accepting new patients
All-Inclusive Community Health Center CurrentSince Sep 26, 2025 Accepting new patients

Locations

1311 N San Fernando Blvd
Burbank, CA 91504
Phone (818) 843-9900

17114 Devonshire St
Ste 200
Northridge, CA 91325
Phone (818) 646-1771

Organizations & group practices 3

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1235940545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 E VERDUGO AVE APT M",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013112",
            "telephone_number": "818-480-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMLAKYAN",
        "first_name": "TAGUI",
        "middle_name": "TINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "9502841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.