Canby Community Clinic Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CANBY COMMUNITY CLINIC INC

Doing business as

Pura Vida Community Clinic

Practice address

7601 Canby Ave
Reseda, CA 91335-2953

Phone

(818) 383-9383

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Jenny Nver Avetisyan

Title

Ceo

Phone

(818) 674-4414

Specialties & licenses 1

Addresses

Other names 1

• Pura Vida Community Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chase C Cho, DO

  • Family Medicine Physician
  • Northridge, CA
  • NPI 1083292296
  Medicare reassignment NPD
• Elizabeth Ruth Caballero

  • Nurse Practitioner
  • Reseda, CA
  • NPI 1134958432
  NPD (past)
• Anush Vardumyan

  • Family Nurse Practitioner
  • Reseda, CA
  • NPI 1922942390
  NPD (past)

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1518686377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 CANBY AVE",
            "address_2": "UNIT 6B",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352953",
            "telephone_number": "818-383-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 CANBY AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352953",
            "telephone_number": "818-383-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANBY COMMUNITY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "AVETISYAN",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "NVER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-674-4414",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PURA VIDA COMMUNITY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pura Vida Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cambridge Labs Inc
• Melissa Hikari-Luttio Campbell, MD
• Sheila Canales, OT
• Canby Care Inc
• Canby Care Inc
• Canby Dental
• Canby Retirement Corporation
• Canby Retirement Corporation
• Candu Lab Services Inc
• Canyon Crest Recovery LLC

• Clinic/Center in Reseda, CA
• Providers in Reseda, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.