Active NPI
Kiran Idrees Malik-Islam, AMFT
- Marriage & Family Therapist
- Orange, CA
National Provider Identifier
1366986788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 165261
- Practice address
- 265 S Anita Dr Ste 102-104
Orange, CA 92868-3355 - Phone
- (714) 410-3500
- NPI assigned
- Dec 5, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 165261 | CA | Primary |
Addresses
Primary practice location
265 S Anita Dr Ste 102-104
Orange, CA 92868-3355
Mailing address
265 S Anita Dr
Orange, CA 92868-3355
Phone (714) 410-3500
Other practice location 1
4221 Avalon Blvd
Los Angeles, CA 90011
Phone (323) 233-0425
Other practice location 2
525 Cabrillo Park Dr Ste 300
Santa Ana, CA 92701-5017
Phone (714) 457-0668
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
| License | State | Type | Specialty |
|---|---|---|---|
| 132358 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exodus Recovery, Inc. | Current | Accepting new patients |
Locations
265 S Anita Dr
Ste 102104
Orange, CA 92868
Phone (714) 410-3500
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.
-
- Community/Behavioral Health Agency
- Orange, CA
- NPI 1326641671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1366986788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 S ANITA DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683355",
"telephone_number": "714-410-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 S ANITA DR STE 102-104",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683355",
"telephone_number": "714-410-3500"
}
],
"practiceLocations": [
{
"address_1": "4221 Avalon Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90011",
"country_code": "US",
"telephone_number": "323-233-0425",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "525 Cabrillo Park Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927015017",
"country_code": "US",
"telephone_number": "714-457-0668",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALIK-ISLAM",
"first_name": "KIRAN",
"middle_name": "IDREES",
"name_prefix": "Mrs.",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-05",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "165261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.