Healthcare Provider Details
I. General information
NPI: 1255904447
Provider Name (Legal Business Name): ASTUTE CARE PATHWAYS, A PROFESSIONAL PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 S BARRINGTON AVE STE 312
LOS ANGELES CA
90025-5379
US
IV. Provider business mailing address
PO BOX 7343
BURBANK CA
91510-7343
US
V. Phone/Fax
- Phone: 424-333-2933
- Fax:
- Phone: 424-333-2933
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0200X |
| Taxonomy | Forensic Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP0814X |
| Taxonomy | Psychoanalysis Psychologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARTYOM
KHACHIKYAN
Title or Position: FOUNDER, CEO
Credential: PSYD
Phone: 424-333-2933