Avina Khiatani, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS019314 Issued in PA

Practice address

150 S Warner Rd Ste 130
King of Prussia, PA 19406-2826

Phone

(484) 705-0585

NPI assigned

May 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1023453586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S WARNER RD STE 130",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062826",
            "telephone_number": "484-705-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S WARNER RD STE 130",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062826",
            "telephone_number": "484-705-0585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191213429",
            "country_code": "US",
            "telephone_number": "215-204-7276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHIATANI",
        "first_name": "AVINA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1288",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS019314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketamine Treatment Centers of Princeton, LLC
• Keystone Dermatology Partners, LLC
• Keystone Neurocare LLC
• Keystone Spine and Sport LLC
• Urmi Khatri, OD
• Jessica Khoury, OD
• Kelly Kilmartin
• David Kim
• Kirstie Kimmel, BCBA, MS. LBS
• Katelyn Marie Kincaid

• Psychologist in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.