Individual provider Active NPI

Anush Petrosyan

  • Clinical Social Worker
  • Escondido, CA
National Provider Identifier
1063196350
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
140062 Issued in CA
Practice address
2556 S Escondido Blvd Unit 414
Escondido, CA 92025-7081
Phone
(818) 621-8454
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 140062 CA Primary

Addresses

Primary practice location

2556 S Escondido Blvd Unit 414
Escondido, CA 92025-7081

Mailing address

8910 Clairemont Mesa Blvd
San Diego, CA 92123-1104
Phone (858) 514-5144

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

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1063196350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231104",
            "telephone_number": "858-514-5144",
            "fax_number": "858-514-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 S ESCONDIDO BLVD UNIT 414",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920257081",
            "telephone_number": "818-621-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSYAN",
        "first_name": "ANUSH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "140062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.