Individual provider Active NPI

Christine Hacobian, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Tarzana, CA
National Provider Identifier
1942967336
Registry record updated Nov 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
21939 Issued in CA
Practice address
18740 Ventura Blvd Ste 206
Tarzana, CA 91356-6334
Phone
(818) 468-4304
NPI assigned
Nov 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 21939 CA Primary

Addresses

Primary practice location

18740 Ventura Blvd Ste 206
Tarzana, CA 91356-6334

Mailing address

17028 Adlon Rd
Encino, CA 91436-3815
Phone (818) 468-4304

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
21939CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1637452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1942967336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17028 ADLON RD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363815",
            "telephone_number": "818-468-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD STE 206",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566334",
            "telephone_number": "818-468-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACOBIAN",
        "first_name": "CHRISTINE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-21",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "21939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.