Individual provider Active NPI

Anahita Gheytanchi, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1538466800
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25467 Issued in CA
Practice address
2035 Westwood Blvd
Suite 208
Los Angeles, CA 90025-6332
Phone
(323) 270-1083
NPI assigned
Feb 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25467 CA Primary
Adult Development & Aging Psychologist 103TA0700X PSY25467 CA

Addresses

Primary practice location

2035 Westwood Blvd
Suite 208
Los Angeles, CA 90025-6332

Mailing address

2035 Westwood Blvd Ste 208
Los Angeles, CA 90025-6342
Phone (310) 709-3073

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25467CAMDAdult Development & Aging Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Gheytanchi PHD, a Psychological Corporation CurrentSince Feb 12, 2023 Accepting new patients

Locations

3301 Ocean Park Blvd
Ste 110
Santa Monica, CA 90405
Phone (310) 709-3073

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1538466800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 WESTWOOD BLVD STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256342",
            "telephone_number": "310-709-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 WESTWOOD BLVD",
            "address_2": "SUITE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256332",
            "telephone_number": "323-270-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEYTANCHI",
        "first_name": "ANAHITA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25467",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY25467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.