Healthcare Provider Details

I. General information

NPI: 1336024744
Provider Name (Legal Business Name): ARNO KHACHATRIAN CADC-II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16946 SHERMAN WAY STE 400
VAN NUYS CA
91406-3613
US

IV. Provider business mailing address

516 STANFORD RD
BURBANK CA
91504-2950
US

V. Phone/Fax

Practice location:
  • Phone: 818-588-5818
  • Fax:
Mailing address:
  • Phone: 818-588-5818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAII051680218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: