Individual provider Active NPI

Elham Hamzeh, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Canoga Park, CA
National Provider Identifier
1265041511
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95017649 Issued in CA
Practice address
6928 Owensmouth Ave # 105
Canoga Park, CA 91303-2095
Phone
(818) 446-6040
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95017649 CA Primary

Addresses

Primary practice location

6928 Owensmouth Ave # 105
Canoga Park, CA 91303-2095

Mailing address

6928 Owensmouth Ave # 105
Canoga Park, CA 91303-2095
Phone (925) 890-3621

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
I20210901003673 CA Practitioner - Nurse Practitioner 7810202256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
808375CAMDRegistered Nurse
NP95017649CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maria I. Seliverstov, MD Inc. CurrentSince Aug 1, 2021 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Dec 28, 2021 Accepting new patients
Green Path Psychiatric Nursing Practitioner Services, Inc. Psychiatric/Mental Health CurrentSince Sep 7, 2023 Accepting new patients

Locations

6928 Owensmouth Ave
Ste 105
Canoga Park, CA 91303
Phone (818) 446-6040

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4835 Van Nuys Blvd
Ste 104
Sherman Oaks, CA 91403
Phone (818) 986-9232

19634 Ventura Blvd
Ste 118
Tarzana, CA 91356
Phone (818) 446-6040

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1265041511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6928 OWENSMOUTH AVE # 105",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032095",
            "telephone_number": "925-890-3621",
            "fax_number": "866-458-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6928 OWENSMOUTH AVE # 105",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032095",
            "telephone_number": "818-446-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMZEH",
        "first_name": "ELHAM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95017649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

Verify at the official NPI Registry.