Individual provider Active NPI

Arineh Ebrahimi

  • Community Health Worker
  • Granada Hills, CA
National Provider Identifier
1366989980
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
10605 Balboa Blvd
Suit # 100
Granada Hills, CA 91344-6342
Phone
(818) 832-6174
Fax
(818) 832-2567
NPI assigned
Jan 20, 2017
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
Suit # 100
Granada Hills, CA 91344-6342

Mailing address

10605 Balboa Blvd
Suit # 100
Granada Hills, CA 91344-6342
Phone (818) 832-6174

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

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1366989980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "SUIT # 100",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-832-6174",
            "fax_number": "818-832-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "SUIT # 100",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-832-6174",
            "fax_number": "818-832-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMI",
        "first_name": "ARINEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.