Individual provider Active NPI

Alin Aivazian

  • Speech-Language Pathologist
  • Glendale, CA
National Provider Identifier
1093510166
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20201 Issued in CA
Practice address
1230 E Windsor Rd
Glendale, CA 91205-2656
Phone
(818) 244-7219
NPI assigned
Feb 13, 2025
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 20201 CA Primary

Addresses

Primary practice location

1230 E Windsor Rd
Glendale, CA 91205-2656

Mailing address

740 S Placentia Ave
Placentia, CA 92870-6832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250221001734 CA Practitioner - Qualified Speech Language Pathologist 2365962230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interface Rehab, Inc.Group PAC ID 6204736556, 10 clinicians

Practice addresses (Care Compare)

774 S Placentia Ave
Suite 200
Placentia, CA 92870-6838
Phone (714) 646-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40618CAMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interface Rehab, Inc. CurrentSince Jan 28, 2025 Accepting new patients
Interface Rehab, Inc. CurrentSince Jan 28, 2025 Accepting new patients

Locations

2400 W Acacia Ave
Hemet, CA 92545
Phone (951) 492-2841

774 S Placentia Ave
Ste 200
Placentia, CA 92870
Phone (714) 646-8300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1093510166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S PLACENTIA AVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E WINDSOR RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052656",
            "telephone_number": "818-244-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIVAZIAN",
        "first_name": "ALIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.