Individual provider Active NPI

Dorna Mahmoodi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • RSM, CA
National Provider Identifier
1104739853
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95041489 Issued in CA
Practice address
21022 Los Alisos Blvd Apt 1724
RSM, CA 92688-3261
Phone
(949) 449-9299
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95041489 CA Primary

Addresses

Primary practice location

21022 Los Alisos Blvd Apt 1724
RSM, CA 92688-3261

Mailing address

21022 Los Alisos Blvd Apt 1724
RSM, CA 92688-3261

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1104739853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21022 LOS ALISOS BLVD APT 1724",
            "city": "RSM",
            "state": "CA",
            "postal_code": "926883261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21022 LOS ALISOS BLVD APT 1724",
            "city": "RSM",
            "state": "CA",
            "postal_code": "926883261",
            "telephone_number": "949-449-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOODI",
        "first_name": "DORNA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95041489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in RSM, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.