Heidi Bazan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

79063 Issued in CA

Practice address

333 S Beaudry Ave
Los Angeles, CA 90017

Phone

(213) 241-3841

Fax

(213) 241-3305

NPI assigned

May 1, 2012

Last updated

Jul 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heidi Piedra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1225396948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "HEIDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "79063",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "PIEDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber Nicole Baysinger, MD, PHD
• Parisa Bazaei, LMFT
• Ilan Bazak, DPM
• Mattea Joy Bazala
• Gilbert D. Bazan
• Ardalan Bazargan-Lari, M.D.
• Anita Bazavilvazo, TECHINICAN
• Renya Bazikian, MA
• Sebouh Bazikian
• Ephrim Bazile

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.