Active NPI
Masoumeh Nourshahi
- Clinical Psychologist
- Simi Valley, CA
National Provider Identifier
1205357456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY34234
- Practice address
- 1227 E Los Angeles Ave
Simi Valley, CA 93065-2871 - Phone
- (805) 582-4075
- Fax
- (805) 582-4075
- NPI assigned
- Jun 28, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY34234 | CA | Primary |
Addresses
Primary practice location
1227 E Los Angeles Ave
Simi Valley, CA 93065-2871
Mailing address
324 S Beverly Dr Ste 1057
Beverly Hills, CA 90212-4822
Phone (747) 302-1198
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34234 | CA | MD | Clinical Psychologist |
| 34234 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Clinical | Current | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 1
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": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1205357456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 S BEVERLY DR STE 1057",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902124822",
"telephone_number": "747-302-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 E LOS ANGELES AVE",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930652871",
"telephone_number": "805-582-4075",
"fax_number": "805-582-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOURSHAHI",
"first_name": "MASOUMEH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2023-08-14",
"certification_date": "2023-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY34234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.