Sourihna Khounphichane

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014199 Issued in CA

Practice address

4912 Kester Ave Apt 106
Sherman Oaks, CA 91403-1690

Phone

(847) 271-3145

NPI assigned

Feb 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD
• Palomar Health

  • General Acute Care Hospital
  • Escondido, CA
  • NPI 1457321317
  NPD (past)

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1427641513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 KESTER AVE APT 106",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031690",
            "telephone_number": "847-271-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 KESTER AVE APT 106",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031690",
            "telephone_number": "847-271-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOUNPHICHANE",
        "first_name": "SOURIHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "businessurl",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "businessurl",
            "address_1": "4912 Kester Ave Apt 106",
            "city": "Sherman Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914031690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Khodakarami
• Ramesh Khorsand
• Nazanin Khorsandi
• Shirin Khorsandian
• Laura Khouban, LMFT
• Andre Elie Khoury, D.C.
• Javad Kiamehr
• Kidney Center of Sherman Oaks, Inc.
• Emily A Kiedman, PH.D.
• Nadia Gabrielle Kilgore, BCBA

• Family Nurse Practitioner in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.