Individual provider Active NPI

Tamara Shahmoradian

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1003282617
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT112994 Issued in CA
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

Updated by the provider on Nov 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7420MedicaidCA
6758MedicaidCA
7068MedicaidCA

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

LicenseStateTypeSpecialty
93830CAMDMarriage & Family Therapist
LMFT112994CAMDMarriage & 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.

Verify at the official NPI Registry.