NPIMap

Organization Active NPI

Heritage Clinic and the Community Assistance Program for Seniors

Doing business as Heritage Los Angeles

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1093049546
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HERITAGE CLINIC AND THE COMMUNITY ASSISTANCE PROGRAM FOR SENIORS
Doing business as
Heritage Los Angeles
Heritage- Mid City
Practice address
3600 Wilshire Blvd Ste 2200
Los Angeles, CA 90010-2632
Phone
(213) 382-4400
Fax
(213) 382-4494
NPI assigned
Sep 30, 2009
Last updated
Feb 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Vatche Kelartinian, MBA
Title
Ceo
Phone
(626) 577-8480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X CA Primary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

3600 Wilshire Blvd Ste 2200
Los Angeles, CA 90010-2632

Mailing address

447 N El Molino Ave
Pasadena, CA 91101-1403
Phone (626) 577-8480

Other names 2

  • Heritage Los Angeles Doing business as
  • Heritage- Mid City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001075 CA Part B Supplier - Clinic/Group Practice 9032005798 Receives reassigned benefits from 20 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pasadena, CA; West Covina, CA; Los Angeles, CA; Long Beach, CA; Lancaster, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Heritage Clinic and the Community Assistance Program for Seniors4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

221 S 6th St
Burbank, CA 91501
Phone (818) 543-8472

200 E Washington Ave
Escondido, CA 92025
Phone (760) 737-8642

201 S Alvarado St
Ste 405
Los Angeles, CA 90057
Phone (213) 382-4400

3600 Wilshire Blvd
Ste 2200
Los Angeles, CA 90010
Phone (213) 382-4400

1037 W Avenue N
Ste 205
Palmdale, CA 93551
Phone (661) 575-9365

253 N San Gabriel Blvd
Ste 100
Pasadena, CA 91107
Phone (626) 577-8480

3740 E Sierra Madre Blvd
Pasadena, CA 91107
Phone (626) 351-5427

1940 Market St
San Diego, CA 92102
Phone (619) 233-3381

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1093049546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011403",
            "telephone_number": "626-577-8480",
            "fax_number": "626-577-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 WILSHIRE BLVD STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102632",
            "telephone_number": "213-382-4400",
            "fax_number": "213-382-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CLINIC AND THE COMMUNITY ASSISTANCE PROGRAM FOR SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "KELARTINIAN",
        "authorized_official_first_name": "VATCHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-577-8480",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage- Mid City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.