Individual provider Active NPI

Artyom Khachikyan, PSYD

  • Clinical Psychologist
  • Burbank, CA
National Provider Identifier
1184968422
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30616 Issued in CA
Practice address
1023 N Hollywood Way
Burbank, CA 91505-2539
Phone
(424) 333-2933
NPI assigned
Nov 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 30616 CA Primary
Psychologist 103T00000X 30616 CA

Addresses

Primary practice location

1023 N Hollywood Way
Burbank, CA 91505-2539

Mailing address

PO Box 7343
Burbank, CA 91510-7343
Phone (424) 333-2933

Other identifiers 1

IdentifierTypeStateIssuer
1184968422MedicaidCA

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

LicenseStateTypeSpecialty
30616CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Astute Care Pathways, a Professional Psychological Corporation Clinical CurrentSince Jul 25, 2021 Accepting new patients

Locations

1023 N Hollywood Way
Ste 105A
Burbank, CA 91505
Phone (424) 333-2933

2001 S Barrington Ave
Ste 312
West Los Angeles, CA 90025
Phone (424) 239-9616

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1184968422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7343",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915107343",
            "telephone_number": "424-333-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N HOLLYWOOD WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052539",
            "telephone_number": "424-333-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHACHIKYAN",
        "first_name": "ARTYOM",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30616",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184968422",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.