Individual provider Active NPI

Vahe Sukiasyan, PSY.D

  • Psychologist
  • Sherman Oaks, CA
National Provider Identifier
1982839437
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY25500 Issued in CA
Practice address
4955 Van Nuys Blvd
Suite 316
Sherman Oaks, CA 91403-1801
Phone
(818) 434-8002
NPI assigned
May 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY25500 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd
Suite 316
Sherman Oaks, CA 91403-1801

Mailing address

4955 Van Nuys Blvd
Suite 316
Sherman Oaks, CA 91403-1801
Phone (818) 434-8002

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
I20150901003186 CA Practitioner - Clinical Psychologist 3375798796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

800 S Central Ave
Suite 207
Glendale, CA 91204-4388
Phone (818) 395-3778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25500CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aosta Clinic Inc CurrentSince Mar 29, 2023 Accepting new patients
Sukiasyan Psychological Services Inc Psychologist CurrentSince Jun 9, 2015 Accepting new patients
Comcare Primary Medical Group a California General Partnership Past Accepting new patients

Locations

800 S Central Ave
Ste 207
Glendale, CA 91204
Phone (747) 215-6998

1101 N Pacific Ave
Ste 103
Glendale, CA 91202
Phone (818) 247-7447

1220 S Central Ave
Ste 205
Glendale, CA 91204
Phone (818) 247-7677

Organizations & group practices 3

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1982839437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 316",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-434-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 316",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-434-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKIASYAN",
        "first_name": "VAHE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.