Active NPI
Anait A Khudagulyan, OCCUPATIONAL THERAPY
- Occupational Therapy Assistant
- Glendale, CA
National Provider Identifier
1598060519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 224 W Dryden St Apt 309
Glendale, CA 91202-3742 - Phone
- (323) 485-7483
- NPI assigned
- Jan 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTA 1168 | CA | |
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
224 W Dryden St Apt 309
Glendale, CA 91202-3742
Mailing address
PO Box 27002
Los Angeles, CA 90027-0002
Phone (323) 485-7483
Other practice location 1
936 E Green St
Suite 110
Pasadena, CA 91106-2900
Phone (323) 656-2449
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 |
|---|---|---|---|
| OTA 1168 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Star Registry Services | Past | Accepting new patients |
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.
-
- Pediatric Occupational Therapist
- Pasadena, CA
- NPI 1114230737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1598060519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27002",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900270002",
"telephone_number": "323-485-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W DRYDEN ST APT 309",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912023742",
"telephone_number": "323-485-7483"
}
],
"practiceLocations": [
{
"address_1": "936 E Green St",
"address_2": "Suite 110",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911062900",
"country_code": "US",
"telephone_number": "323-656-2449",
"fax_number": "323-656-1464",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHUDAGULYAN",
"first_name": "ANAIT",
"middle_name": "A",
"credential": "OCCUPATIONAL THERAPY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OTA 1168",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.