Individual provider Active NPI

Jaclyn Ayvazyan, PHARMD

  • Pharmacist
  • Burbank, CA
National Provider Identifier
1962957308
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69979 Issued in CA
Practice address
511 N Hollywood Way
Burbank, CA 91505-3406
Phone
(818) 339-5805
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69979 CA Primary

Addresses

Primary practice location

511 N Hollywood Way
Burbank, CA 91505-3406

Mailing address

511 N Hollywood Way
Burbank, CA 91505-3406
Phone (818) 339-5805

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
69979CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aaa Care RX Inc Current Accepting new patients

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1962957308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N HOLLYWOOD WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053406",
            "telephone_number": "818-339-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N HOLLYWOOD WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053406",
            "telephone_number": "818-339-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYVAZYAN",
        "first_name": "JACLYN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "69979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.