Individual provider Active NPI

Yasaman Mostajeran, PHD

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1043507635
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
128509 Issued in CA
Practice address
1151 Dove St Ste 105
Newport Beach, CA 92660-2805
Phone
(949) 878-7882
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMF66273 CA
Clinical Child & Adolescent Psychologist 103TC2200X CA
Rehabilitation Counselor 225C00000X
Marriage & Family Therapist 106H00000X 128509 CA Primary

Addresses

Primary practice location

1151 Dove St Ste 105
Newport Beach, CA 92660-2805

Mailing address

3200 Motor Ave
Los Angeles, CA 90034-3740
Phone (310) 836-1223

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000092 CA Practitioner - Marriage and Family Therapist 8022451020 Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
IMF66273CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nava Mindfulness Center Marriage & Family Therapist CurrentSince Jan 2, 2024 Accepting new patients

Locations

1151 Dove St
Ste 105
Newport Beach, CA 92660
Phone (949) 723-1993

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1043507635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343740",
            "telephone_number": "310-836-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 105",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602805",
            "telephone_number": "949-878-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAJERAN",
        "first_name": "YASAMAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF66273",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.