Avid Khorram, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14341 Issued in CA

Practice address

701 Garden View Court
20
Encinitas, CA 92024

Phone

(760) 635-0044

Fax

(760) 635-0044

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043247497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GARDEN VIEW COURT",
            "address_2": "20",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-635-0044",
            "fax_number": "760-635-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GARDEN VIEW COURT",
            "address_2": "20",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-635-0044",
            "fax_number": "760-635-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORRAM",
        "first_name": "AVID",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keven Tagdiri, MD, Inc.
• Chil Khakham, ND
• Renuka Kharkar, M.D.
• Datis Kharrazian, D.C., D.H.SC.
• Wendy Ann Khentigan, MD
• Sarah Khorram, CNM
• Shawn Thomas Kidd, D.C.
• Monica Ann Kieffer, D.O.
• Ray J. Kieffer Jr., DDS
• Alexia Killen

• Clinical Psychologist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.