Individual provider Active NPI

Maya Elyashkevich, PSY.D.

  • Adult Development & Aging Psychologist
  • Camarillo, CA
National Provider Identifier
1750408183
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
PSY17165 Issued in CA
Practice address
1722 S Lewis Rd
Camarillo, CA 93012-8520
Phone
(805) 445-7887
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X PSY17165 CA Primary
Clinical Psychologist 103TC0700X PSY 17165 CA
Clinical Child & Adolescent Psychologist 103TC2200X PSY17165 CA

Addresses

Primary practice location

1722 S Lewis Rd
Camarillo, CA 93012-8520

Mailing address

18600 Burbank Blvd Apt 207
Tarzana, CA 91356-2663
Phone (818) 809-9519

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

State licenses

LicenseStateTypeSpecialty
17185CAMDMental Health Counselor
PSY17165CAMDAdult Development & Aging Psychologist
PSY 17165CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Doctors Medical Group Inc. PastSince Jan 1, 2007 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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1750408183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18600 BURBANK BLVD APT 207",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562663",
            "telephone_number": "818-809-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-445-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELYASHKEVICH",
        "first_name": "MAYA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY17165",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 17165",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY17165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.