Soha Heidari Gonzalez, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27712 Issued in CA

Practice address

2880 Cochran St # 1009
Simi Valley, CA 93065-0700

Phone

(818) 971-9194

Fax

(855) 270-9495

NPI assigned

Jul 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• CPF SJN Outpatient, LLC

  • Clinical Psychologist
  • Houston, TX
  • NPI 1730830001
  Medicare reassignment NPD

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1275799298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 COCHRAN ST # 1009",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650700",
            "telephone_number": "818-971-9194",
            "fax_number": "855-270-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 COCHRAN ST # 1009",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650700",
            "telephone_number": "818-971-9194",
            "fax_number": "855-270-9495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 Williams St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930652887",
            "country_code": "US",
            "telephone_number": "818-971-9194",
            "fax_number": "855-270-9495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SOHA",
        "middle_name": "HEIDARI",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Branae K Gonsalves, ASW
• Emma Gonzales
• Gonzalez Dental Group
• Arnaldo Gonzalez, DDS
• Paola Gonzalez
• Brenda Marie Goshorn, RDN
• David Gouda
• Mikhail Granin
• John Frank Grauch V, M.D.
• Gravitas Home Health, Inc

• Clinical Psychologist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.