Individual provider Active NPI

Menije Boduryan, PSY.D.

  • Mental Health Counselor
  • Calabasas, CA
National Provider Identifier
1386874790
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
26351 Issued in CA
Practice address
4505 Las Virgenes Rd
Suite 205
Calabasas, CA 91302-1956
Phone
(818) 575-6148
NPI assigned
Jul 20, 2009
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 26351 CA Primary

Addresses

Primary practice location

4505 Las Virgenes Rd
Suite 205
Calabasas, CA 91302-1956

Mailing address

7112 Darnoch Way
West Hills, CA 91307-1835
Phone (818) 575-6148

Other identifiers 2

IdentifierTypeStateIssuer
7420MedicaidCA
7068MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 26, 2026 through Feb 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26351CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Menije Psychotherapy Inc Mental Health Current Accepting new patients

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, 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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1386874790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 DARNOCH WAY",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071835",
            "telephone_number": "818-575-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 LAS VIRGENES RD",
            "address_2": "SUITE 205",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021956",
            "telephone_number": "818-575-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODURYAN",
        "first_name": "MENIJE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "26351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.