Individual provider Active NPI

Marina Vardanyan

  • Adult Health Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1609786144
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95041251 Issued in CA
Practice address
1311 N San Fernando Blvd
Burbank, CA 91504-4236
Phone
(818) 843-9900
NPI assigned
Sep 8, 2026
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 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 Practitioner 363LA2200X 95041251 CA Primary

Addresses

Primary practice location

1311 N San Fernando Blvd
Burbank, CA 91504-4236

Mailing address

16101 Tulsa St
Granada Hills, CA 91344-5341
Phone (818) 330-3397

Other practice location 1

17114 Devonshire St Ste 200
Northridge, CA 91325-1687
Phone (818) 646-1771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95041251CAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1609786144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 TULSA ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445341",
            "telephone_number": "818-330-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N SAN FERNANDO BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044236",
            "telephone_number": "818-843-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17114 Devonshire St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913251687",
            "country_code": "US",
            "telephone_number": "818-646-1771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARDANYAN",
        "first_name": "MARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95041251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.