Active NPI
Lily Mojdehi
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1114748159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 148376
- Practice address
- 2423 Camino del Rio S Ste 103
San Diego, CA 92108-3734 - Phone
- (619) 293-3741
- NPI assigned
- Oct 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 148376 | CA | Primary |
Addresses
Primary practice location
2423 Camino del Rio S Ste 103
San Diego, CA 92108-3734
Mailing address
PO Box 8722
La Jolla, CA 92038-8722
Other practice location 1
911 Catalina Blvd
San Diego, CA 92106-2838
Phone (619) 293-3741
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148376 | CA | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1114748159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8722",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920388722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2423 CAMINO DEL RIO S STE 103",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083734",
"telephone_number": "619-293-3741"
}
],
"practiceLocations": [
{
"address_1": "911 Catalina Blvd",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921062838",
"country_code": "US",
"telephone_number": "619-293-3741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOJDEHI",
"first_name": "LILY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-22",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "148376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.