Family Psychological Clinic Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

FAMILY PSYCHOLOGICAL CLINIC INC

Practice address

12301 Califa St
Valley Village, CA 91607-1106

Phone

(310) 500-5193

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Shully Salman, PSYDNPI 1558695049

Title

Owner

Phone

(310) 500-5193

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shully Salman

  • Clinical Psychologist
  • Valley Village, CA
  • NPI 1558695049
  Medicare reassignment NPD Authorized official
• Carol Jean Owen, PHD

  • Adult Development & Aging Psychologist
  • Encino, CA
  • NPI 1487296422
  NPD
• Omar Romero Nunez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1932472800
  NPD (past)
• Zhina N/a Vartanian, LCSW

  • Clinical Social Worker
  • Sylmar, CA
  • NPI 1356869200
  NPD (past)

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1265289300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 CALIFA ST",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916071106",
            "telephone_number": "310-500-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 CALIFA ST",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916071106",
            "telephone_number": "310-500-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PSYCHOLOGICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "SALMAN",
        "authorized_official_first_name": "SHULLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-500-5193",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benita Evazyan, DMD
• Evercare at Home
• Excellerated Home Health, Inc.
• Kimia Faghihi, D.C.
• Marc Fajardo
• Noushin Fani, DDS
• Jamie Farrell
• Tali Finkelstein Fayfel
• Barry Dean Feinstein
• Crystal M. Felice, PHARMD

• Clinical Psychologist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.