Individual provider Active NPI

John Arthur Ayvazian, PH.D.

  • Clinical Psychologist
  • North Hollywood, CA
National Provider Identifier
1922052380
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 17149 Issued in CA
Practice address
12520 Magnolia Blvd
# 300
North Hollywood, CA 91607-2336
Phone
(818) 388-4108
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 17149 CA Primary

Addresses

Primary practice location

12520 Magnolia Blvd
# 300
North Hollywood, CA 91607-2336

Mailing address

12520 Magnolia Blvd
# 300
North Hollywood, CA 91607-2336
Phone (818) 388-4108

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060612000306 CA Practitioner - Clinical Psychologist 4082626023 Reassigns benefits to 1 organization
Practice locations: Valley Village, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 17149CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Psych Services Inc Clinical CurrentSince May 3, 2018 Accepting new patients
Darrell Broaddus Psychological Services PC Clinical PastSince Jul 9, 2020 Accepting new patients

Locations

2335 Mountain Ave
Duarte, CA 91010
Phone (626) 357-3207

12501 Chandler Blvd
Ste 102
Valley Vlg, CA 91607
Phone (818) 414-4162

Organizations & group practices 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922052380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD",
            "address_2": "# 300",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916072336",
            "telephone_number": "818-388-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD",
            "address_2": "# 300",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916072336",
            "telephone_number": "818-388-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYVAZIAN",
        "first_name": "JOHN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 17149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.