Amanda J. Khan, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32361 Issued in CA

Practice address

501 W Broadway Ste A587
San Diego, CA 92101-3536

Phone

(619) 273-0129

NPI assigned

Sep 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619308800000",
    "number": "1225438708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE A587",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013536",
            "telephone_number": "619-273-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE A587",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013536",
            "telephone_number": "619-273-0129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Centre St",
            "address_purpose": "LOCATION",
            "city": "West Roxbury",
            "state": "MA",
            "postal_code": "021323316",
            "country_code": "US",
            "telephone_number": "617-325-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AMANDA",
        "middle_name": "J.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2021-04-25",
        "certification_date": "2021-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265E",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soraiya Khamisa
• Boris Khamishon, NEUROLOGY
• Terrie Khammao
• Parasto Khamooshian
• Muhammad Khan KK, DPT
• Anoushey Khan, AMFT
• Ayesha Khan, MD
• Fahad Habib Khan, MD
• Farheen Akhter Khan
• Hashim Ali Khan, M.D

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2021; 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.