Active NPI
Ayla Gouzoubachian, R.D.
- Registered Dietitian
- Glendale, CA
National Provider Identifier
1497074462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 991090
- Practice address
- 1420 S Central Ave
Glendale, CA 91204-2508 - Phone
- (818) 502-1900
- NPI assigned
- May 28, 2010
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 991090 | CA | Primary |
Addresses
Primary practice location
1420 S Central Ave
Glendale, CA 91204-2508
Mailing address
1420 S Central Ave
Glendale, CA 91204-2508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991090 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282003200000",
"number": "1497074462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 S CENTRAL AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 S CENTRAL AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042508",
"telephone_number": "818-502-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUZOUBACHIAN",
"first_name": "AYLA",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2010-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "991090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.