Active NPI
Elizabeth Maratovna Khavkina, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Panorama City, CA
National Provider Identifier
1073376612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95037175
- Practice address
- 14860 Roscoe Blvd Ste 307
Panorama City, CA 91402-4691 - Phone
- (818) 616-2122
- NPI assigned
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95037175 | CA | Primary |
| Registered Nurse | 163W00000X | 95311194 | CA |
Addresses
Primary practice location
14860 Roscoe Blvd Ste 307
Panorama City, CA 91402-4691
Mailing address
11901 Louise Ave
Granada Hills, CA 91344-2449
Phone (323) 717-9626
Other practice location 1
20301 Ventura Blvd Ste 202
Woodland Hills, CA 91364-0923
Phone (323) 717-9626
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95311194 | CA | MD | Registered Nurse |
| 95037175 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1073376612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11901 LOUISE AVE",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913442449",
"telephone_number": "323-717-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14860 ROSCOE BLVD STE 307",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914024691",
"telephone_number": "818-616-2122"
}
],
"practiceLocations": [
{
"address_1": "20301 Ventura Blvd Ste 202",
"address_purpose": "LOCATION",
"city": "Woodland Hills",
"state": "CA",
"postal_code": "913640923",
"country_code": "US",
"telephone_number": "323-717-9626",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAVKINA",
"first_name": "ELIZABETH",
"middle_name": "MARATOVNA",
"name_prefix": "Miss",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95037175",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95311194",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.