Individual provider Active NPI

Nazanin Khatami

  • Marriage & Family Therapist
  • Mountain View, CA
National Provider Identifier
1104319912
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
115410 Issued in CA
Practice address
1503 Grant Rd
Mountain View, CA 94040-3292
Phone
(650) 484-1176
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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 115410 CA Primary

Addresses

Primary practice location

1503 Grant Rd
Mountain View, CA 94040-3292

Mailing address

524 Everett CT
Palo Alto, CA 94301-1525
Phone (858) 722-2080

Other practice location 1

616 Ramona St Ste 23
Palo Alto, CA 94301-2541
Phone (650) 720-7744

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
I20240822002059 CA Practitioner - Marriage and Family Therapist 3870032832 Reassigns benefits to 1 organization
Practice locations: Palo Alto, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momentum for HealthGroup PAC ID 2769377217, 41 clinicians

Practice addresses (Care Compare)

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 938-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115410CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum for Health Current Accepting new patients
Momentum for Health CurrentSince Jun 9, 2024 Accepting new patients
Momentum for Health CurrentSince Jun 9, 2024 Accepting new patients
Momentum for Health PastSince Jun 8, 2025 Accepting new patients

Locations

206 California Ave
Palo Alto, CA 94306
Phone (650) 617-8340

2001 The Alameda
San Jose, CA 95126
Phone (408) 938-6750

1922 The Alameda
Ste 316
San Jose, CA 95126
Phone (408) 637-0341

Organizations & group practices 4

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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1104319912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 EVERETT CT",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011525",
            "telephone_number": "858-722-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 GRANT RD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403292",
            "telephone_number": "650-484-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 Ramona St Ste 23",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943012541",
            "country_code": "US",
            "telephone_number": "650-720-7744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATAMI",
        "first_name": "NAZANIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.