Organization Active NPI

Sukiasyan Psychological Services Inc

  • Psychologist
  • Glendale, CA
National Provider Identifier
1548647100
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY25500 Issued in CA
Legal business name
SUKIASYAN PSYCHOLOGICAL SERVICES INC
Practice address
1220 S Central Ave
205
Glendale, CA 91204-2547
Phone
(818) 434-8002
NPI assigned
May 4, 2015
Last updated
May 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Mr. Vahe Sukiasyan, PSY DNPI 1982839437
Title
President
Phone
(818) 434-8002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY25500 CA Primary

Addresses

Primary practice location

1220 S Central Ave
205
Glendale, CA 91204-2547

Mailing address

700 S 6TH St
202
Burbank, CA 91501-2512
Phone (818) 434-8002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150831002770 CA Part B Supplier - Clinic/Group Practice 3971819384 Receives reassigned benefits from 2 practitioners
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

1220 S Central Ave
Ste 205
Glendale, CA 91204
Phone (818) 247-7677

800 S Central Ave
Ste 207
Glendale, CA 91204
Phone (747) 215-6998

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1548647100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S 6TH ST",
            "address_2": "202",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012512",
            "telephone_number": "818-434-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE",
            "address_2": "205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042547",
            "telephone_number": "818-434-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUKIASYAN PSYCHOLOGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "SUKIASYAN",
        "authorized_official_first_name": "VAHE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-434-8002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25500",
            "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 May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.