Individual provider Active NPI

Shirley Mona Kahenzadeh, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Beverly Hills, CA
National Provider Identifier
1386843035
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS23427 Issued in CA
Practice address
9300 Wilshire Blvd
Suite 320
Beverly Hills, CA 90212-3213
Phone
(310) 285-9300
Fax
(310) 285-9300
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS23427 CA Primary

Addresses

Primary practice location

9300 Wilshire Blvd
Suite 320
Beverly Hills, CA 90212-3213

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 285-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20120724000736 CA Practitioner - Clinical Social Worker 1153587811 Reassigns benefits to 2 organizations
Practice locations: Beverly Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of California Los AngelesGroup PAC ID 4587857727, 84 clinicians

Practice addresses (Care Compare)

11303 W Washington Blvd
Suite 100
Los Angeles, CA 90066-6003
Phone (310) 391-7281

1801 Wilshire Blvd
Santa Monica, CA 90403-5609
Phone (310) 319-5098

Merit-based Incentive Payment System (MIPS)

Final score
87.46 of 100Reported as group
Quality
80.82
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23427CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Feb 5, 2020 Accepting new patients
Regents of the University of California Los Angeles CurrentSince Jul 1, 2013 Accepting new patients

Locations

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1801 Wilshire Blvd
Santa Monica, CA 90403
Phone (310) 319-5098

2001 Santa Monica Blvd
Ste 860W
Santa Monica, CA 90404
Phone (310) 586-9097

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1386843035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-285-9300",
            "fax_number": "310-285-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 WILSHIRE BLVD",
            "address_2": "SUITE 320",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123213",
            "telephone_number": "310-285-9300",
            "fax_number": "310-285-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHENZADEH",
        "first_name": "SHIRLEY",
        "middle_name": "MONA",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.