Individual provider Active NPI

Alicia Vanee Kazarians, NP

  • Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1154518041
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
601856 Issued in CA
Practice address
3160 E del Mar Blvd
Pasadena, CA 91107-4649
Phone
(626) 270-2400
Fax
(626) 270-2496
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 601856 CA Primary

Addresses

Primary practice location

3160 E del Mar Blvd
Pasadena, CA 91107-4649

Mailing address

3160 E del Mar Blvd
Pasadena, CA 91107-4649
Phone (626) 270-2400

Other identifiers 3

IdentifierTypeStateIssuer
1154518041MedicaidCA
13161113145MedicaidCA
NP17521OtherCANP LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1154518041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 E DEL MAR BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074649",
            "telephone_number": "626-270-2400",
            "fax_number": "626-270-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 E DEL MAR BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074649",
            "telephone_number": "626-270-2400",
            "fax_number": "626-270-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZARIANS",
        "first_name": "ALICIA",
        "middle_name": "VANEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "601856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154518041",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13161113145",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LIC",
            "identifier": "NP17521",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.