Active NPI
Anna Ilinichna Khijniak, M.D.
- Psychiatry Physician
- Torrance, CA
National Provider Identifier
1427220417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A114016
- Practice address
- 1000 W Carson St
Torrance, CA 90502-2059 - Phone
- (424) 306-5853
- NPI assigned
- Mar 31, 2008
- Last updated
- Jun 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A114016 | CA | Primary |
Addresses
Primary practice location
1000 W Carson St
Torrance, CA 90502-2059
Mailing address
1000 West Carson Street
BLDG 1 South
Torrance, CA 90502
Phone (424) 306-5853
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07142037 | Other | ECFMG ID # | |
| A114016 | Other | CA | CALI THE MEDICAL BOARD OF CALIFORNIA |
Other names 1
- Dr. Anna Ilinichna Davidovich
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611002445 | CA | Order and Referring Only - Psychiatry | 9032409883 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114016 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1427220417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 WEST CARSON STREET",
"address_2": "BLDG 1 SOUTH",
"city": "TORRANCE",
"state": "CA",
"postal_code": "90502",
"telephone_number": "424-306-5853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W CARSON ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905022059",
"telephone_number": "424-306-5853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHIJNIAK",
"first_name": "ANNA",
"middle_name": "ILINICHNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A114016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECFMG ID #",
"identifier": "07142037",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALI THE MEDICAL BOARD OF CALIFORNIA",
"identifier": "A114016",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "DAVIDOVICH",
"middle_name": "ILINICHNA",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.