Glenda Josefina Moghim, MFTI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122988 Issued in CA

Practice address

6850 Van Nuys Blvd Ste 202
Van Nuys, CA 91405

Phone

(818) 786-2079

NPI assigned

Jul 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Virginia Baldioli Family Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Van Nuys, CA
  • NPI 1699331462

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1013493626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15089 ENCANTO DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914034409",
            "telephone_number": "818-636-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 VAN NUYS BLVD STE 202",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91405",
            "telephone_number": "818-786-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHIM",
        "first_name": "GLENDA",
        "middle_name": "JOSEFINA",
        "name_prefix": "Mrs.",
        "credential": "MFTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT83387",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Age Home Health, Inc.
• Modern Age Hospice, Imc.
• Modern Day Home Health Care Inc
• Mehdi Amini Moghadam, MID
• Bahman Moghaddas
• Arash Moghimi, M.D.
• Marjan Mohammadi, DDS
• Liana Moini
• Dannia Mojica
• Dinaris Mojica

• Marriage & Family Therapist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.