Individual provider Active NPI

Madlen Ayvazian, LCSW

  • Clinical Social Worker
  • Simi Valley, CA
National Provider Identifier
1033305149
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28402 Issued in CA
Practice address
50 Mollison Dr
Simi Valley, CA 93065-5381
Phone
(805) 941-0289
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 28402 CA Primary

Addresses

Primary practice location

50 Mollison Dr
Simi Valley, CA 93065-5381

Mailing address

50 Mollison Dr
Simi Valley, CA 93065-5381
Phone (805) 941-0289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250811002613 CA Practitioner - Clinical Social Worker 5193223964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cyti Health PCGroup PAC ID 4587012950, 34 clinicians

Practice addresses (Care Compare)

11801 Pierce St
Riverside, CA 92505-4408
Phone (866) 478-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28402CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince May 30, 2025 Accepting new patients
Foothill Family Service Past Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1033305149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOLLISON DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655381",
            "telephone_number": "805-941-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOLLISON DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655381",
            "telephone_number": "805-941-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYVAZIAN",
        "first_name": "MADLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.