Individual provider Active NPI

Mahzadeh Nourizadeh, NP

  • Nurse Practitioner
  • Orange, CA
National Provider Identifier
1508999301
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16158 Issued in CA
Practice address
700 S Tustin St
Orange, CA 92866-3425
Phone
(714) 922-4100
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16158 CA Primary

Addresses

Primary practice location

700 S Tustin St
Orange, CA 92866-3425

Mailing address

10792 Center Dr
Villa Park, CA 92861-6412
Phone (714) 335-8802

Other names 1

  • Mahzadeh Nourizadeh Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16158CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood/Orange and San Bernardino Counties, Inc. Past Accepting new patients

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1508999301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10792 CENTER DR",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928616412",
            "telephone_number": "714-335-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663425",
            "telephone_number": "714-922-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURIZADEH",
        "first_name": "MAHZADEH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "16158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAHZADEH",
            "last_name": "NOURIZADEH",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.