Active NPI
Sadaf Moghimi
- Student in an Organized Health Care Education/Training Program
- Fresno, CA
National Provider Identifier
1013379023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 290 N Wayte LN Ste 2500
Fresno, CA 93701-2124 - Phone
- (559) 459-5725
- NPI assigned
- Mar 28, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
290 N Wayte LN Ste 2500
Fresno, CA 93701-2124
Mailing address
290 N Wayte LN Ste 2500
Fresno, CA 93701-2124
Phone (559) 459-5725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190312003605 | CA | Order and Referring Only - Dentist | 3971843806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101613 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459123200000",
"number": "1013379023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 N WAYTE LN STE 2500",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012124",
"telephone_number": "559-459-5725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 N WAYTE LN STE 2500",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012124",
"telephone_number": "559-459-5725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHIMI",
"first_name": "SADAF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-28",
"last_updated": "2016-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.