Healthcare Provider Details

I. General information

NPI: 1598616823
Provider Name (Legal Business Name): HERITAGE SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 ATLANTIC AVE STE 103
LONG BEACH CA
90807-3529
US

IV. Provider business mailing address

3939 ATLANTIC AVE STE 103
LONG BEACH CA
90807-3529
US

V. Phone/Fax

Practice location:
  • Phone: 562-264-6001
  • Fax: 562-264-6006
Mailing address:
  • Phone: 562-264-6001
  • Fax: 562-264-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: VATCHE KELARTINIAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 626-577-8480