ANDREW JOHN PETKUS (NPI# 1184152241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184152241 |
| Entity Type | Individual |
| Full Name | ANDREW JOHN PETKUS |
| Credential | PH.D. |
| Practice Address |
1520 San Pablo St Ste 3000 Los Angeles CA 90033-5315 |
| Mailing Address |
Po Box 31309 Los Angeles CA 90031-0309 |
| Practice Telephone | 3234425710 |
| Mailing Telephone | 3234425710 |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY-28858 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1520 SAN PABLO ST STE 3000 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90033-5315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649200494 | Daniel Minoru Togasaki | Psychiatry & Neurology | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2006-07-04 |
| 1083235469 | Caroline Alexis Crane | Registered Nurse | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2020-04-27 |
| 1942850888 | Jillian A. Polonchak | Nurse Practitioner | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2019-09-12 |
| 1669031969 | Jane J Vigil | Nurse Practitioner | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033 | 2019-06-10 |
| 1720503030 | Janet E. Greenwood | Physician Assistant | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2017-08-08 |
| 1750732657 | Tae Chan Paul Yang | Physical Medicine & Rehabilitation | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2016-06-22 |
| 1467808014 | Amin Sanei Moghaddam | Psychiatry & Neurology | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2016-05-12 |
| 1790131407 | Ana Gjurgevich | Nurse Practitioner | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2016-05-11 |
| 1659726230 | Shivani J. Shah | Psychiatry & Neurology | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2016-05-02 |
| 1720432404 | Brigitte Furth Hurtubise | Psychiatry & Neurology | 1520 San Pablo St Ste 3000, Los Angeles, CA 90033-5315 | 2016-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376165050 | Noa Yee | Student in an Organized Health Care Education/Training Program | 1200 N. State Street, Gnh 1011, Los Angeles, CA 90033 | 2020-05-15 |
| 1629690144 | Monica Lopez | Respiratory Therapist, Registered | 1251 Marengo St, Los Angeles, CA 90033 | 2020-05-07 |
| 1649890401 | Antonio Hernandez Saenz | Student in an Organized Health Care Education/Training Program | 1200 N. State Street Gnh 1060k, Los Angeles, CA 90033 | 2020-04-22 |
| 1417585100 | Kelsey Grace Shea | Student in an Organized Health Care Education/Training Program | 1200 N State St Ird 112, Los Angeles, CA 90033 | 2020-03-30 |
| 1891322780 | Carolyn Kan | Student in an Organized Health Care Education/Training Program | 1200 North State Street Clinic Tower, Suite A7d, Los Angeles, CA 90033 | 2020-03-23 |
| 1902445786 | Maury M Hopkins | Registered Nurse | 1883 Marengo Street, Los Angeles, CA 90033 | 2019-12-27 |
| 1982259792 | Beverly Austin Mccabe | Registered Nurse | 1720 E. Cesar Chavez Ave., Los Angeles, CA 90033 | 2019-08-08 |
| 1093369399 | Christine Yoon | Pharmacist | 1611 E Cesar Chavez Ave, Los Angeles, CA 90033 | 2019-07-25 |
| 1073075339 | Johanna Keller | Student in an Organized Health Care Education/Training Program | La County +usc Medical Center, 2051 Marengo Street, Los Angeles, CA 90033 | 2019-04-04 |
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| Find all providers in zip 90033 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1679189377 | Dr. Sandra Jeanne Brim, Ph.d. | Psychologist | 11601 Gorham Ave Apt 1, Los Angeles, CA 90049-4738 | 2020-09-17 |
| 1194330274 | Marilyn S Zweifach | Psychologist | 3606 Barry Avenue, Los Angeles, CA 90066 | 2020-09-15 |
| 1538787874 | Molly Burrets | Psychologist | 5619 N Figueroa St Apt 219, Los Angeles, CA 90042-4979 | 2020-07-13 |
| 1770100737 | Mary Carde | Psychologist | 1572 Ensley Ave, Los Angeles, CA 90024-5325 | 2020-06-25 |
| 1134745193 | Bloom Psychology, Inc. | Psychologist | 3800 Barham Blvd Ste 420, Los Angeles, CA 90068-1042 | 2020-06-24 |
| 1639799406 | Joseph Aguayo | Psychologist | 11849 W Olympic Blvd Ste 202, Los Angeles, CA 90064-1148 | 2020-04-22 |
| 1912536020 | Butterflly Health, Inc. | Psychologist | 3530 Wilshire Blvd Ste 1650, Los Angeles, CA 90010-2371 | 2020-04-02 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90033 |
Please comment or provide details below to improve the information on ANDREW JOHN PETKUS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.