Individual provider Active NPI

Anna Yaralyan, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1295921419
Registry record updated Oct 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24157 Issued in CA
Practice address
3171 Los Feliz Blvd Ste 208B
Los Angeles, CA 90039
Phone
(323) 928-2240
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2019

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 24157 CA Primary

Addresses

Primary practice location

3171 Los Feliz Blvd Ste 208B
Los Angeles, CA 90039

Mailing address

4622 3/4 Prospect Ave
Los Angeles, CA 90027-5305
Phone (323) 356-7390

Other practice location 1

3171 Los Feliz Blvd Ste 208B
Los Angeles, CA 90039
Phone (323) 928-2240

Other identifiers 2

IdentifierTypeStateIssuer
24157OtherCALICENSE NUMBER CA
24157OtherCAPROFESSIONAL LICENSE

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
I20191004002131 CA Practitioner - Clinical Psychologist 2466783451 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3171 Los Feliz Blvd
Los Angeles, CA 90039-1527
Phone (323) 928-2240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24157CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570233600000",
    "number": "1295921419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 3/4 PROSPECT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275305",
            "telephone_number": "323-356-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3171 LOS FELIZ BLVD STE 208B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90039",
            "telephone_number": "323-928-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3171 Los Feliz Blvd Ste 208B",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90039",
            "country_code": "US",
            "telephone_number": "323-928-2240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YARALYAN",
        "first_name": "ANNA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2019-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER CA",
            "identifier": "24157",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "24157",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.