DR. PHILIP MARTIN TAKAKJIAN (PH.D.) – Clinical Psychologist, NPI 1225052889

DR. PHILIP MARTIN TAKAKJIAN (PH.D.) is a healthcare provider. based in Emeryville, California. specializing in Clinical Psychologist. They hold the professional credentials PH.D.. They hold a License No. PSY15142 (CA). The NPI Number for DR. PHILIP MARTIN TAKAKJIAN (PH.D.) is 1225052889

Main info

Male
Sole Proprietor
Name
DR. PHILIP MARTIN TAKAKJIAN (PH.D.)
NPI
1225052889
Phone
(415) 296-5290
Address
1480 64TH ST STE 150
Enumeration Date
27 July 2006
Last Update Date
30 November 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for DR. PHILIP MARTIN TAKAKJIAN (PH.D.)

  • 1480 64TH ST STE 150

    EMERYVILLE, CA 946082267

    Phone: (415) 296-5290

    Fax: (415) 296-5299

    Type: Location

  • Citibank, 702, Marshall Street, Redwood City, San Mateo County, California, 94063, United States

    SUITE 415

    REDWOOD CITY, CA 940631829

    Phone: (650) 685-4228

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-27

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240627001262IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94608)

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Reviews

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Frequently asked questions

Is there an official ID for DR. PHILIP MARTIN TAKAKJIAN (PH.D.) in U.S. healthcare records?
The official identifier for DR. PHILIP MARTIN TAKAKJIAN (PH.D.) is NPI 1225052889.
Would DR. PHILIP MARTIN TAKAKJIAN (PH.D.) appear as active to a payer?
You can treat DR. PHILIP MARTIN TAKAKJIAN (PH.D.) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. PHILIP MARTIN TAKAKJIAN (PH.D.)?
DR. PHILIP MARTIN TAKAKJIAN (PH.D.)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. PHILIP MARTIN TAKAKJIAN (PH.D.)?
Travel planning: use Emeryville, California as the reference point for DR. PHILIP MARTIN TAKAKJIAN (PH.D.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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