Healthcare Provider Details

I. General information

NPI: 1164013314
Provider Name (Legal Business Name): AVETIS TOPCHYAN, PSY.D., A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2021
Last Update Date: 01/31/2021
Certification Date: 01/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16661 VENTURA BLVD. SUITE 400
ENCINO CA
91436
US

IV. Provider business mailing address

16746 TUPPER ST.
NORTHRIDGE CA
91343
US

V. Phone/Fax

Practice location:
  • Phone: 747-208-3288
  • Fax:
Mailing address:
  • Phone: 747-208-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AVETIS AVO TOPCHYAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PSY.D.
Phone: 747-208-3288