Individual provider Active NPI

Mona Bourbour Shirazi Kordi

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Forest, CA
National Provider Identifier
1265385496
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95038494 Issued in CA
Practice address
23832 Rockfield Blvd Ste 120
Lake Forest, CA 92630-2870
Phone
(714) 769-6090
NPI assigned
Feb 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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 NP95038494 CA Primary

Addresses

Primary practice location

23832 Rockfield Blvd Ste 120
Lake Forest, CA 92630-2870

Mailing address

5242 Molino
Irvine, CA 92618-4833
Phone (949) 870-7289

Other names 1

  • Mona Shirazi Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95038494CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1265385496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 MOLINO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184833",
            "telephone_number": "949-870-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 120",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302870",
            "telephone_number": "714-769-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBOUR SHIRAZI KORDI",
        "first_name": "MONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95038494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "SHIRAZI",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.