Active NPI
Tamara Shahmoradian
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1003282617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT112994
- Practice address
- 3910 Oakwood Ave
Los Angeles, CA 90004-3413 - Phone
- (213) 709-6975
- NPI assigned
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 93830 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | LMFT112994 | CA | Primary |
Addresses
Primary practice location
3910 Oakwood Ave
Los Angeles, CA 90004-3413
Mailing address
3910 Oakwood Ave
Los Angeles, CA 90004-3413
Phone (213) 709-6975
Other practice location 1
1540 E Colorado St
Glendale, CA 91205-1514
Phone (818) 244-7257
Other practice location 2
12450 Van Nuys Blvd
Suite 200
Pacoima, CA 91331-1391
Phone (818) 896-1161 ext. 325
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7420 | Medicaid | CA | |
| 6758 | Medicaid | CA | |
| 7068 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93830 | CA | MD | Marriage & Family Therapist |
| LMFT112994 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1003282617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3910 OAKWOOD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043413",
"telephone_number": "213-709-6975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3910 OAKWOOD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043413",
"telephone_number": "213-709-6975"
}
],
"practiceLocations": [
{
"address_1": "1540 E Colorado St",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "CA",
"postal_code": "912051514",
"country_code": "US",
"telephone_number": "818-244-7257",
"fax_number": "818-243-5431",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12450 Van Nuys Blvd",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Pacoima",
"state": "CA",
"postal_code": "913311391",
"country_code": "US",
"telephone_number": "818-896-1161 x325",
"fax_number": "818-896-5069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAHMORADIAN",
"first_name": "TAMARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-18",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "93830",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT112994",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7420",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6758",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7068",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.