Individual provider Active NPI

Vishal Sanghavi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Covina, CA
National Provider Identifier
1417820606
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95036759 Issued in CA
Practice address
1161 E Covina Blvd
Covina, CA 91724-1523
Phone
(909) 279-1740
NPI assigned
Sep 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95036759 CA Primary

Addresses

Primary practice location

1161 E Covina Blvd
Covina, CA 91724-1523

Mailing address

1161 E Covina Blvd
Covina, CA 91724-1523
Phone (909) 279-1740

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231002754 CA Practitioner - Nurse Practitioner 9537655279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1161 E Covina Blvd
Covina, CA 91724-1523
Phone (909) 279-1740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95036759CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cyrus Nasserian MD Cesar Cruz MD Sambin Wang DO and Zaheib Idrees D CurrentSince Dec 1, 2025 Accepting new patients

Locations

200 Freedom Ln
Aliso Viejo, CA 92656
Phone (213) 928-2194

1441 Michigan Ave
Beaumont, CA 92223
Phone (951) 769-2500

1161 E Covina Blvd
Covina, CA 91724
Phone (626) 859-5289

800 E 5th St
Ontario, CA 91764
Phone (909) 984-1620

11878 Avenue of Industry
San Diego, CA 92128
Phone (619) 736-7421

801 Seneca St
Ventura, CA 93001
Phone (805) 504-6814

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.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1417820606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 E COVINA BLVD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241523",
            "telephone_number": "909-279-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 E COVINA BLVD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241523",
            "telephone_number": "909-279-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGHAVI",
        "first_name": "VISHAL",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95036759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.