Healthcare Provider Details
I. General information
NPI: 1033065388
Provider Name (Legal Business Name): AXIS PSYCHIATRIC MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9350 WILSHIRE BLVD STE 203
BEVERLY HILLS CA
90212-3204
US
IV. Provider business mailing address
5130 KLUMP AVE APT 710
NORTH HOLLYWOOD CA
91601-5058
US
V. Phone/Fax
- Phone: 818-618-6229
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDRANIK
ALAVERDYAN
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 818-618-6227