Individual provider Active NPI

Angelika Boyadzhyan

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1245879071
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT87047 Issued in CA
Practice address
679 S New Hampshire Ave Ste 400
Los Angeles, CA 90005-1355
Phone
(626) 254-5000
NPI assigned
Dec 26, 2019
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT87047 CA Primary

Addresses

Primary practice location

679 S New Hampshire Ave Ste 400
Los Angeles, CA 90005-1355

Mailing address

15053 Victory Blvd Unit 4
Van Nuys, CA 91411-1849
Phone (818) 207-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201004067 CA Practitioner - Marriage and Family Therapist 8820441140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT87047CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince Dec 27, 2023 Accepting new patients
Pacific Clinics CurrentSince Dec 27, 2023 Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

679 S New Hampshire Ave
Ste 400
Los Angeles, CA 90005
Phone (213) 639-2500

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

Organizations & group practices 3

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": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1245879071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15053 VICTORY BLVD UNIT 4",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111849",
            "telephone_number": "818-207-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 S NEW HAMPSHIRE AVE STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051355",
            "telephone_number": "626-254-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYADZHYAN",
        "first_name": "ANGELIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT87047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.