Active NPI
Sarosh Motivala, PHD
- Adult Development & Aging Psychologist
- Los Angeles, CA
National Provider Identifier
1043364060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- PSY21159
- Practice address
- 300 Medical PLZ
Los Angeles, CA 90095-0001 - Phone
- (310) 825-9989
- NPI assigned
- Jan 23, 2007
- Last updated
- Aug 7, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | PSY21159 | CA | Primary |
Addresses
Primary practice location
300 Medical PLZ
Los Angeles, CA 90095-0001
Mailing address
5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 301-8708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21159 | CA | MD | Adult Development & Aging Psychologist |
| 21159 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asha Inc | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218067200000",
"number": "1043364060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455632",
"telephone_number": "310-301-8708",
"fax_number": "310-301-8751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001",
"telephone_number": "310-825-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTIVALA",
"first_name": "SAROSH",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2008-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "CA",
"license": "PSY21159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.