TATEVIK GRIGORYAN NPI 1477302305

NPI Information

  • NPI: 1477302305
  • Provider Name: TATEVIK GRIGORYAN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 39159 PASEO PADRE PKWY STE 121
    FREMONT, CA
    ZIP 94538
  • Phone: (510) 952-1190

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NPI Details

Tatevik Grigoryan is a psychiatric/mental health nurse practitioner in Fremont, CA. Tatevik Grigoryan NPI is 1477302305. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

39159 PASEO PADRE PKWY STE 121
FREMONT, CA
ZIP 94538-600
Phone: (510) 952-1190
Fax: (510) 972-5976

The NPI 1477302305 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/14/2024 and was last updated on 5/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse95222787CALIFORNIANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health95028093CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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