Active NPI
Mina Lynn Sardashti, M.D.
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1467985499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 172248
- Practice address
- 3830 Valley Centre Dr Ste 705-821
San Diego, CA 92130-3320 - Phone
- (858) 215-2349
- Fax
- (858) 614-7572
- NPI assigned
- Apr 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 172248 | CA | Primary |
Addresses
Primary practice location
3830 Valley Centre Dr Ste 705-821
San Diego, CA 92130-3320
Mailing address
3830 Valley Centre Dr Ste 705-821
San Diego, CA 92130-3320
Phone (858) 215-2349
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220223001281 | CA | Practitioner - Psychiatry | 1456622646 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172248 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Purple Sage Psychiatry, Inc. | Psychiatry | Current | Accepting new patients |
Locations
3830 Valley Centre Dr
Ste 705821
San Diego, CA 92130
Phone (858) 215-2349
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.
-
- Psychiatry Physician
- San Diego, CA
- NPI 1902623440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1467985499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3830 VALLEY CENTRE DR STE 705-821",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303320",
"telephone_number": "858-215-2349",
"fax_number": "858-614-7572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 VALLEY CENTRE DR STE 705-821",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303320",
"telephone_number": "858-215-2349",
"fax_number": "858-614-7572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARDASHTI",
"first_name": "MINA",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-06",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "172248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.