Active NPI
Sara Kassabian
- Marriage & Family Therapist
- Santa Monica, CA
National Provider Identifier
1336806058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 129216
- Practice address
- 312 Arizona Avenue
Santa Monica, CA 90401 - Phone
- (916) 415-8789
- NPI assigned
- Nov 17, 2021
- Reactivated
- Mar 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 129216 | CA | Primary |
Addresses
Primary practice location
312 Arizona Avenue
Santa Monica, CA 90401
Mailing address
PO Box 2521
Granite Bay, CA 95746-2521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 3, 2024 through Mar 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129216 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1336806058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2521",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957462521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 ARIZONA AVENUE",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90401",
"telephone_number": "916-415-8789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSABIAN",
"first_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-17",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"deactivation_date": "2022-01-29",
"reactivation_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "129216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.