Healthcare Provider Details

I. General information

NPI: 1851254270
Provider Name (Legal Business Name): ANDRANIK ALAVERDYAN PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
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

9350 WILSHIRE BLVD STE 203
BEVERLY HILLS CA
90212-3204
US

V. Phone/Fax

Practice location:
  • Phone: 310-304-0818
  • Fax: 310-304-1179
Mailing address:
  • Phone: 310-304-0818
  • Fax: 310-304-1179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: