Individual provider Active NPI

Mehry Khazan, M.A MFT

  • Marriage & Family Therapist
  • Marina, CA
National Provider Identifier
1053709220
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
299 Twelfth Street
Marina, CA 93933
Phone
(831) 647-7652
Fax
(831) 647-7940
NPI assigned
Dec 22, 2014
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

299 Twelfth Street
Marina, CA 93933

Mailing address

299 Twelfth Street
Marina, CA 93933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1053709220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 TWELFTH STREET",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "93933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 TWELFTH STREET",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "93933",
            "telephone_number": "831-647-7652",
            "fax_number": "831-647-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZAN",
        "first_name": "MEHRY",
        "name_prefix": "Ms.",
        "credential": "M.A MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.