NPIMap

Organization Active NPI

Heritage Clinic and the Community Assistance Program for Seniors

Doing business as Heritage Clinic Comm for Seniors

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1306899091
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2255549 Issued in CA
Legal business name
HERITAGE CLINIC AND THE COMMUNITY ASSISTANCE PROGRAM FOR SENIORS
Doing business as
Heritage Clinic Comm for Seniors
Practice address
253 N San Gabriel Blvd Ste 100
Pasadena, CA 91107-3429
Phone
(626) 577-8480
Fax
(626) 577-8978
NPI assigned
May 17, 2006
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Mr. Vatche Kelartinian, MBA
Title
Ceo
Phone
(626) 577-8480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2255549 CA Primary
Case Manager/Care Coordinator 171M00000X
Supports Brokerage Agency 251X00000X

Addresses

Primary practice location

253 N San Gabriel Blvd Ste 100
Pasadena, CA 91107-3429

Mailing address

447 N El Molino Ave
Pasadena, CA 91101-1403
Phone (626) 577-8480

Other names 1

  • Heritage Clinic Comm for Seniors Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001075 CA Part B Supplier - Clinic/Group Practice 9032005798 Receives reassigned benefits from 20 practitioners
5 other NPIs on this enrollment
Practice locations: Pasadena, CA; West Covina, CA; Los Angeles, CA; Long Beach, CA; Lancaster, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Heritage Clinic and the Community Assistance Program for Seniors4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3600 Wilshire Blvd
Ste 2200
Los Angeles, CA 90010
Phone (213) 382-4400

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1306899091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011403",
            "telephone_number": "626-577-8480",
            "fax_number": "626-577-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 N SAN GABRIEL BLVD STE 100",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073429",
            "telephone_number": "626-577-8480",
            "fax_number": "626-577-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CLINIC AND THE COMMUNITY ASSISTANCE PROGRAM FOR SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "KELARTINIAN",
        "authorized_official_first_name": "VATCHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-577-8480",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "2255549",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Clinic Comm for Seniors",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Clinic Comm for Seniors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.