Individual provider Active NPI

Michelle Mohammadian

  • Marriage & Family Therapist
  • Elk Grove, CA
National Provider Identifier
1053771295
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
8788 Elk Grove Blvd Ste D
Elk Grove, CA 95624-1767
Phone
(916) 400-0505
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 Primary

Addresses

Primary practice location

8788 Elk Grove Blvd Ste D
Elk Grove, CA 95624-1767

Mailing address

3900 H St Apt 4
Sacramento, CA 95819-2755
Phone (408) 373-4403

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 7, 2024 through May 7, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W. Renee Martin Licensed Clinical Social Worker CurrentSince Jun 25, 2023 Accepting new patients
Whole Wellness Therapy, a Licensed Clinical Social Worker Corporation Mental Health PastSince Jun 4, 2023 Accepting new patients

Locations

8788 Elk Grove Blvd
Ste D
Elk Grove, CA 95624
Phone (916) 400-0505

Organizations & group practices 2

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1053771295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 H ST APT 4",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192755",
            "telephone_number": "408-373-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 ELK GROVE BLVD STE D",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241767",
            "telephone_number": "916-400-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMADIAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.