Elena R Kvichko, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A89532 Issued in CA

Practice address

5762 Bolsa Ave Ste 107
Huntington Beach, CA 92649-1172

Phone

(714) 898-0362

Fax

(714) 893-3262

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Elena R Kvitchko Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Associated Therapists, Inc.

  • Psychologist
  • Huntington Beach, CA
  • NPI 1801977319

  Psychiatry

  NPD
• Autism 360 Support LLC

  • Clinical Social Worker
  • Huntington Beach, CA
  • NPI 1639802382
  NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1902926439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28364 S WESTERN AVE # 494",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "818-618-2412",
            "fax_number": "714-893-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5762 BOLSA AVE STE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491172",
            "telephone_number": "714-898-0362",
            "fax_number": "714-893-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVICHKO",
        "first_name": "ELENA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A89532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITES STATES OF AMERICA PASSPORT",
            "identifier": "486059932",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DRIVER LICENSE",
            "identifier": "A8771500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KVITCHKO",
            "middle_name": "R",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nathanael Kurtzman
• Nicole Elizabeth Kuske, DDS
• Arina Kussainova
• Nailya Kutzhanova
• Adam Kutzner, D.D.S.
• Seoyeon Kwak
• Danny P Kwan, DDS
• Kevin Chinglin Kwan, DDS
• Huevi La
• Nina Hong Quyen La, D.C., L.AC.

• Psychiatry Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.