KATAYOUN MOINI PA (Credential# 743941) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2019. The license expiration date date is October 31, 2020. The license status is ACTIVE.
KATAYOUN MOINI PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002192. The credential type is physician assistant. The effective date is November 1, 2019. The expiration date is October 31, 2020. The business address is 1184 Cypress Ave. Apt. 1, Hermosa Beach, CA 90254. The current status is active.
| Licensee Name | KATAYOUN MOINI PA |
| Credential ID | 743941 |
| Credential Number | 23.002192 |
| Credential Type | Physician Assistant |
| Business Address |
1184 Cypress Ave. Apt. 1 Hermosa Beach CA 90254 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-10-20 |
| Effective Date | 2019-11-01 |
| Expiration Date | 2020-10-31 |
| Refresh Date | 2019-07-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 972141 | CSP.0049210 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-10-25 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 1184 Cypress Ave. Apt. 1 |
| City | Hermosa Beach |
| State | CA |
| Zip Code | 90254 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| The Lemon Perfect Company | 205 Pier Ave, Ste 201, Hermosa Beach, CA 90254 | Securities - Exemptions | 2020-04-29 ~ |
| Amy L Polvani | 429 Manhattan Ave., Hermosa Beach, CA 90254 | Registered Nurse | 2010-04-01 ~ 2011-03-31 |
| Lori A Leach | 901 15 Th St, Hermosa Beach, CA 90254 | Occupational Therapist | ~ 1995-07-31 |
| Taylor Lys · Lys-mcclanahan | 1228 Corona St, Hermosa Beach, CA 90254 | Barber | 1997-06-16 ~ 1998-08-31 |
| Francis G Alberta | 435 30th Street, Hermosa Beach, CA 90254 | Physician/surgeon | 2003-03-03 ~ 2004-01-31 |
| Jorge L Trujillo | 2001 P C H Apt 106, Hermosa Beach, CA 90254 | Emergency Medical Technician | ~ 1996-01-01 |
| Stefanie M Cappellino | 2434 Hermosa Avenue, Hermosa Beach, CA 90254 | Registered Nurse | 1998-02-23 ~ 1999-04-30 |
| Barry L Cottle | 107 24th St, Hermosa Beach, CA 90254-2554 | Lottery Or Otb Service Provider Management | 2019-09-01 ~ 2020-08-31 |
| Tiffany M Brown | 1717 Manhattan Ave Apt 3, Hermosa Beach, CA 90254-3457 | Occupational Therapist | 2017-08-10 ~ 2019-07-31 |
| City | Hermosa Beach |
| Zip Code | 90254 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Hermosa Beach |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mohammad Moini | 1795 Main St, Springfield, MA 01103 | Dentist | 2015-12-01 ~ 2016-11-30 |
| Katayoun Mohajerani | 20540 Blairmoore St, Chatsworth, CA 91311-2447 | Dentist | 2019-02-01 ~ 2020-01-31 |
| Katayoun F Meyer | 1135 Smith Ridge Road, New Canaan, CT 06840 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Theresa V Horvath | Physiican Assistant Institute, Bridgeport, CT 06604 | Physician Assistant | 2018-10-01 ~ 2019-09-30 |
| Quinnipiac University Physician Assistant Student Society | 370 Bassett Rd, North Haven, CT 06473-4201 | Raffle Permit Class 1 | 2017-01-12 ~ 2017-04-08 |
| Connecticut Dermatology Physician Assistant Society Inc. | Po Box 847, Manchester, CT 06045 | Public Charity-exempt From Financial Requirements | ~ |
| Gretchen Treves | Physician One Urgent Care, Brookfield, CT 06804 | Physician Assistant | ~ |
| Justin S Boyarsky | 560 1st Ave, New York, NY 10016-6402 | Physician Assistant | ~ |
| James H Brown | 11-c Cos Cob Ave, Cos Cob, CT 06807 | Physician Assistant | 2005-11-15 ~ 2006-11-30 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).