Individual provider Active NPI

Sera Khaneshan

  • Marriage & Family Therapist
  • Glendale, CA
National Provider Identifier
1194525519
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT151961 Issued in CA
Practice address
700 N Central Ave Ste 340
Glendale, CA 91203-4238
Phone
(818) 649-2921
NPI assigned
Mar 14, 2025
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 AMFT151961 CA Primary

Addresses

Primary practice location

700 N Central Ave Ste 340
Glendale, CA 91203-4238

Mailing address

460 E Santa Anita Ave Apt 106
Burbank, CA 91501-2985
Phone (818) 484-6671

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

LicenseStateTypeSpecialty
AMFT151961CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Endzone, a Marriage and Family Therapy Corporation CurrentSince Jun 23, 2025 Accepting new patients
The Journey Forward, Licensed Marriage and Family Therapy , Inc. Marriage & Family Therapist PastSince Mar 1, 2025 Accepting new patients

Locations

700 N Central Ave
Ste 340
Glendale, CA 91203
Phone (818) 275-8411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1194525519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E SANTA ANITA AVE APT 106",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012985",
            "telephone_number": "818-484-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N CENTRAL AVE STE 340",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034238",
            "telephone_number": "818-649-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANESHAN",
        "first_name": "SERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT151961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.