Individual provider Active NPI

Annie Varvaryan

  • Clinical Psychologist
  • Montrose, CA
National Provider Identifier
1215277264
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30402 Issued in CA
Practice address
2303 Florencita Ave
Montrose, CA 91020-1817
Phone
(818) 275-0559
NPI assigned
Feb 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 30402 CA Primary

Addresses

Primary practice location

2303 Florencita Ave
Montrose, CA 91020-1817

Mailing address

2303 Florencita Ave
Montrose, CA 91020-1817

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
30402CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Couch Conversations Psychotherapy and Counseling, Inc. Clinical CurrentSince Jul 17, 2021 Accepting new patients

Locations

2303 Florencita Ave
Montrose, CA 91020
Phone (626) 201-1717

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": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1215277264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 FLORENCITA AVE",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 FLORENCITA AVE",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201817",
            "telephone_number": "818-275-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARVARYAN",
        "first_name": "ANNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.