Petros Adzhyan, LEP, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-6627 Issued in CA

Practice address

5565 Canoga Ave Apt 321
Woodland HLS, CA 91367-6654

Phone

(818) 634-2326

NPI assigned

Jun 27, 2016

Last updated

Jun 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1699126086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913650752",
            "telephone_number": "818-634-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 CANOGA AVE APT 321",
            "city": "WOODLAND HLS",
            "state": "CA",
            "postal_code": "913676654",
            "telephone_number": "818-634-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADZHYAN",
        "first_name": "PETROS",
        "credential": "LEP, BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-09-6627",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "LEP 2813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Woodland HLS, CA
• Providers in Woodland HLS, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.