Active NPI
Melissa Petrosian
- Marriage & Family Therapist
- Canoga Park, CA
National Provider Identifier
1942598479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 94916
- Practice address
- 6800 Owensmouth Ave Ste 310
Canoga Park, CA 91303-4245 - Phone
- (818) 347-8565
- NPI assigned
- Jul 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 94916 | CA | Primary |
Addresses
Primary practice location
6800 Owensmouth Ave Ste 310
Canoga Park, CA 91303-4245
Mailing address
25570 The Old Rd # 1127
Valencia, CA 91381-1705
Phone (818) 473-9088
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
215 S Hickory St
Escondido, CA 92025-4359
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94916 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Healthcare | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1598703647
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1437335353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1942598479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25570 THE OLD RD # 1127",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913811705",
"telephone_number": "818-473-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 OWENSMOUTH AVE STE 310",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913034245",
"telephone_number": "818-347-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROSIAN",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-18",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "94916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.