Myrna Kordab

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4641 Fulton Dr NW
Canton, OH 44718-2384

Phone

(330) 433-6075

NPI assigned

Jun 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Child Guidance Center, Inc.

  • Community/Behavioral Health Agency
  • Fullerton, CA
  • NPI 1003936311
  NPD (past)

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1558103259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 POINTE DR",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928217637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Langsdorf Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928313702",
            "country_code": "US",
            "telephone_number": "714-871-9264 x516",
            "fax_number": "714-871-9264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORDAB",
        "first_name": "MYRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merita Konstantacos, RN,MSN, CCNS
• Abhijit Kontamwar, MD
• Varsha Konyala, M.D.
• Annie Elizabeth Koprivec
• Kimberly Kay Koprivec
• Khalil B Korkor, M.D.
• Sheila Marie Korosy
• Kaitlyn R Kortokrax, LPCC
• Melanie M Kosco, PTA
• Jennifer S Kosmides, MS, RD, LD

• Student in an Organized Health Care Education/Training Program in Canton, OH
• Providers in Canton, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.