Individual provider Active NPI

Dezire Khosravi

  • Family Nurse Practitioner
  • Downey, CA
National Provider Identifier
1235096629
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95039556 Issued in CA
Practice address
8357 Florence Ave
Downey, CA 90240-3928
Phone
(661) 998-6728
NPI assigned
Jan 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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 NP95039556 CA Primary
Registered Nurse 163W00000X RN95376376 CA

Addresses

Primary practice location

8357 Florence Ave
Downey, CA 90240-3928

Mailing address

6720 Valley Circle Blvd
West Hills, CA 91307-2809

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
I20260619001641 CA Practitioner - Nurse Practitioner 3577912526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4310 Eve Rd
Simi Valley, CA 93063-2323

6720 Valley Circle Blvd
West Hills, CA 91307-2809

PO Box
Suite 530
Simi Valley, CA 93062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN95376376CAMDRegistered Nurse
NP95039556CAMDFamily Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1235096629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 VALLEY CIRCLE BLVD",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8357 FLORENCE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902403928",
            "telephone_number": "661-998-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVI",
        "first_name": "DEZIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95039556",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95376376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.