Individual provider Active NPI

Harutyun Vahan Ayvazyan

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1770473910
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
PMH06250135 Issued in CA
Practice address
601 N Kenwood St Unit 106
Glendale, CA 91206-2372
Phone
(818) 804-9525
NPI assigned
Jul 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X PMH06250135 CA Primary

Addresses

Primary practice location

601 N Kenwood St Unit 106
Glendale, CA 91206-2372

Mailing address

601 N Kenwood St Unit 106
Glendale, CA 91206-2372

Other practice location 1

6851 Lennox Ave Ste 105
Van Nuys, CA 91405-4073
Phone (866) 557-7924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327003253 CA Practitioner - Nurse Practitioner 4981189941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12913 Harbor Blvd
Suite Q 3 292
Garden Grove, CA 92840-5856

4453 Firmament Ave
Encino, CA 91436-3104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PMH06250135CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Mind Health Inc. CurrentSince Jan 14, 2026 Accepting new patients

Locations

6851 Lennox Ave
Ste 405
Van Nuys, CA 91405
Phone (866) 557-7924

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1770473910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N KENWOOD ST UNIT 106",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N KENWOOD ST UNIT 106",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062372",
            "telephone_number": "818-804-9525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6851 Lennox Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054073",
            "country_code": "US",
            "telephone_number": "866-557-7924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYVAZYAN",
        "first_name": "HARUTYUN",
        "middle_name": "VAHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "PMH06250135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.