Individual provider Active NPI

Roxana Nowbari

  • Student in an Organized Health Care Education/Training Program
  • La Jolla, CA
National Provider Identifier
1063281954
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9500 Gilman Dr Dept 602
La Jolla, CA 92093-0602
Phone
(858) 534-2230
NPI assigned
Dec 20, 2023
Reactivated
Jul 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

9500 Gilman Dr Dept 602
La Jolla, CA 92093-0602

Mailing address

4067 Miramar St # 5123
La Jolla, CA 92037-1329
Phone (424) 333-1067

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

Practice roles

OrganizationSpecialtyStatusNew patients
Accelerated Behavioral Change, Inc. Behavior Technician CurrentSince Dec 24, 2023 Accepting new patients

Locations

16400 Ventura Blvd
Ste 327
Encino, CA 91436
Phone (747) 221-4222

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": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1063281954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 MIRAMAR ST # 5123",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371329",
            "telephone_number": "424-333-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR DEPT 602",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930602",
            "telephone_number": "858-534-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWBARI",
        "first_name": "ROXANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "deactivation_date": "2026-05-01",
        "reactivation_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.