| Heritage Clinic Comm For Seniors | |
|
253 N San Gabriel Blvd Ste 100 Pasadena CA 91107-3429 | |
| (626) 577-8480 | |
| (626) 577-8978 |
| Full Name | Heritage Clinic Comm For Seniors |
|---|---|
| Speciality | Psychologist |
| Location | 253 N San Gabriel Blvd Ste 100, Pasadena, California |
| Authorized Official Name and Position | Vatche Kelartinian (CEO) |
| Authorized Official Contact | 6265778480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Clinic Comm For Seniors 447 N El Molino Ave Pasadena CA 91101-1403 Ph: (626) 577-8480 | Heritage Clinic Comm For Seniors 253 N San Gabriel Blvd Ste 100 Pasadena CA 91107-3429 Ph: (626) 577-8480 |
| NPI Number | 1306899091 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 07/22/2024 |
| Certification Date | 07/22/2024 |
| Medicare PECOS PAC ID | 9032005798 |
|---|---|
| Medicare Enrollment ID | O20040412001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306899091 | NPI | - | NPPES |
| Provider Name | Cynthia L Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235185653 PECOS PAC ID: 0244224392 Enrollment ID: I20060127000519 |
| Provider Name | Lauren F Macmillan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477506509 PECOS PAC ID: 5698780567 Enrollment ID: I20060214000289 |
| Provider Name | Robin M Kietzman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508972753 PECOS PAC ID: 7618972167 Enrollment ID: I20060915000584 |
| Provider Name | Jill E Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508825761 PECOS PAC ID: 6103823422 Enrollment ID: I20061030000615 |
| Provider Name | Elizabeth Grigor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255428785 PECOS PAC ID: 3072554047 Enrollment ID: I20080423000750 |
| Provider Name | Lilian Badovsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598959363 PECOS PAC ID: 8527122282 Enrollment ID: I20090213000052 |
| Provider Name | Christy S Waters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831249630 PECOS PAC ID: 2163611757 Enrollment ID: I20110113000246 |
| Provider Name | Janet Anderson Yang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386690469 PECOS PAC ID: 8224217666 Enrollment ID: I20110201000138 |
| Provider Name | Jennifer Dergregorian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952650038 PECOS PAC ID: 3375867955 Enrollment ID: I20150131000062 |
| Provider Name | Grace S Kim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669507851 PECOS PAC ID: 3577888171 Enrollment ID: I20150202000878 |
| Provider Name | Erwin Munoz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184993602 PECOS PAC ID: 7719275247 Enrollment ID: I20161014001905 |
| Provider Name | Haig Goenjian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831487438 PECOS PAC ID: 2163703133 Enrollment ID: I20170105001484 |
| Provider Name | Gail E Burmeister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275698623 PECOS PAC ID: 1254691249 Enrollment ID: I20180213001359 |
| Provider Name | Victoria E Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396121711 PECOS PAC ID: 4486088150 Enrollment ID: I20200106001539 |
| Provider Name | Aaron M Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306192398 PECOS PAC ID: 7618213067 Enrollment ID: I20211021002858 |
| Provider Name | Carlos R Santell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871073239 PECOS PAC ID: 4082000625 Enrollment ID: I20220406002270 |
| Provider Name | Norma Alicia Rubio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548730807 PECOS PAC ID: 5496136210 Enrollment ID: I20220725002485 |
| Provider Name | Emma S Hernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710019989 PECOS PAC ID: 5395188361 Enrollment ID: I20240206004337 |
| Provider Name | Dennis P Hagerty |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1447451372 PECOS PAC ID: 1557704533 Enrollment ID: I20240206004430 |
| Provider Name | Lisa S Wong |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396298667 PECOS PAC ID: 4183067168 Enrollment ID: I20240206004487 |
| Provider Name | Shawn A Herz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003150442 PECOS PAC ID: 3375987258 Enrollment ID: I20240219003174 |
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