Individual provider Active NPI

Julie Lauren Tatian, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Porter Ranch, CA
National Provider Identifier
1538890512
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021296 Issued in CA
Practice address
11401 Porter Ranch Dr Apt 3205
Porter Ranch, CA 91326-4633
Phone
(818) 746-0376
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 95021296 CA Primary

Addresses

Primary practice location

11401 Porter Ranch Dr Apt 3205
Porter Ranch, CA 91326-4633

Mailing address

11401 Porter Ranch Dr Apt 3205
Porter Ranch, CA 91326-4633
Phone (818) 746-0376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opted out of Medicare
Yes, effective Jun 10, 2026 through Jun 10, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216001548 CA Practitioner - Nurse Practitioner 1850763038 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021296CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation Single Specialty CurrentSince Oct 22, 2022 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1538890512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 PORTER RANCH DR APT 3205",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264633",
            "telephone_number": "818-746-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 PORTER RANCH DR APT 3205",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264633",
            "telephone_number": "818-746-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATIAN",
        "first_name": "JULIE",
        "middle_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porter Ranch, CA

Sources for this page

Verify at the official NPI Registry.