Angie Sophia Iraheta

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW84476 Issued in CA

Practice address

13130 Burbank Blvd
Sherman Oaks, CA 91401

Phone

(818) 781-0360

NPI assigned

Jan 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1063929693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13130 BURBANK BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914016000",
            "telephone_number": "818-781-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13130 BURBANK BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-781-0360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16500 Ventura Blvd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914365050",
            "country_code": "US",
            "telephone_number": "818-788-1003",
            "fax_number": "818-616-5193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRAHETA",
        "first_name": "ANGIE",
        "middle_name": "SOPHIA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW84476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.