Individual provider Active NPI

Artin Alexandrian

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1417443136
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95009349 Issued in CA
Practice address
510 S Grand Ave Ste 400
Glendora, CA 91741-4207
Phone
(818) 279-4058
NPI assigned
Jul 5, 2018
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95009349 CA Primary

Addresses

Primary practice location

510 S Grand Ave Ste 400
Glendora, CA 91741-4207

Mailing address

510 S Grand Ave Ste 400
Glendora, CA 91741-4207
Phone (626) 914-1980

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181206003225 CA Practitioner - Nurse Practitioner 9335483031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holistic Healthcare ServicesGroup PAC ID 5799123352, 6 clinicians

Practice addresses (Care Compare)

5901 W Olympic Blvd
Suite 404
Los Angeles, CA 90036-4669
Phone (818) 279-4058

Merit-based Incentive Payment System (MIPS)

Final score
77.19 of 100Reported as group
Quality
53.33
Improvement activities
40
Cost
52.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009349CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Healthcare Services CurrentSince Jan 14, 2024 Accepting new patients
William Gillespie and Associates Inc. CurrentSince Aug 1, 2018 Accepting new patients
Culver City Psychological Associates, Inc. Past Accepting new patients

Locations

510 S Grand Ave
Ste 200
Glendora, CA 91741
Phone (626) 914-1980

5901 W Olympic Blvd
Ste 404
Los Angeles, CA 90036
Phone (323) 928-9999

1626 Montana Ave
Ste 645
Santa Monica, CA 90403

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1417443136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE STE 400",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414207",
            "telephone_number": "626-914-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE STE 400",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414207",
            "telephone_number": "818-279-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDRIAN",
        "first_name": "ARTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95009349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.