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General NPI Number Information
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NPI Number | 1598616823
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Entity Type | Organization
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Legal Business Name | HERITAGE SENIOR SERVICES
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 3939 ATLANTIC AVE STE 103
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City | LONG BEACH
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State | CA
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Zip | 90807-3529
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Country | US
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Telephone | 562-264-6001
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Fax | 562-264-6006
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Provider Business Mailing Address
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Address Line | 3939 ATLANTIC AVE STE 103
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City | LONG BEACH
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State | CA
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Zip | 90807-3529
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Country | US
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Telephone | 562-264-6001
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Fax | 562-264-6006
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | VATCHE KELARTINIAN
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Credential |
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Telephone | 626-577-8480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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