Individual provider Active NPI

Christine Taheran, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Placentia, CA
National Provider Identifier
1144642109
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP6444 Issued in CA
Practice address
120 Downey Lane
Placentia, CA 92870
Phone
(714) 494-5850
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP6444 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP6444 CA Primary

Addresses

Primary practice location

120 Downey Lane
Placentia, CA 92870

Mailing address

120 Downey Lane
Placentia, CA 92870
Phone (714) 494-5850

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200422002771 CA Practitioner - Nurse Practitioner 4486084084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

6320 Canoga Ave
FL 15
Woodland Hills, CA 91367-2563
Phone (877) 515-8113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6444CAMDOptometrist
NP6444CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince May 28, 2024 Accepting new patients
Oc Progressive Recovery Inc CurrentSince May 31, 2023 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1 Harbor Dr
Ste 300
Sausalito, CA 94965
Phone (415) 223-0222

6320 Canoga Ave
Fl 15
Woodland Hls, CA 91367
Phone (818) 588-4003

Interoperability endpoints

  • Direct secure messaging: ctaheran2893686@oc.providencedirect.org

Organizations & group practices 2

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": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1144642109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DOWNEY LANE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-494-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DOWNEY LANE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-494-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHERAN",
        "first_name": "CHRISTINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP6444",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP6444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.