Amir Mahdavi, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30512 Issued in CA

Practice address

15456 Ventura Blvd Ste 500
Sherman Oaks, CA 91403-3023

Phone

(818) 917-7773

NPI assigned

Jul 4, 2010

Last updated

Apr 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brighter Future Psychological Services Inc

  • Psychologist
  • Sherman Oaks, CA
  • NPI 1972118974
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1278201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1396057550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4403",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913084403",
            "telephone_number": "818-917-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15456 VENTURA BLVD STE 500",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033023",
            "telephone_number": "818-917-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDAVI",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-04",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020974",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CB322340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giselle Madrigal
• Sharlyne Madrigal
• Jacqueline Madueno
• Magnolia Oaks Physical Therapy Apc (JMP Physical Therapy)
• Carla Magtira
• Zainab Mahmoud, MD
• Mahshid Borna DDS, Inc
• Caroline Main
• Veronica Maio
• Max Emanuel Maisel, PHD

• Clinical Psychologist in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.