Kim Khazeni, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LS12335 Issued in CA

Practice address

14751 Plaza Dr
Suite F
Tustin, CA 92780-2702

Phone

(949) 509-3041

Fax

(714) 544-4472

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inner Peace Psychotherapy, PC

  • Community/Behavioral Health Agency
  • Tustin, CA
  • NPI 1598179814
  NPD (past)
• Pointer Psychotherapy, Inc

  • Clinical Psychologist
  • Tustin, CA
  • NPI 1962984013
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558434035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14751 PLAZA DR",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802702",
            "telephone_number": "949-509-3041",
            "fax_number": "714-544-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14751 PLAZA DR",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802702",
            "telephone_number": "949-509-3041",
            "fax_number": "714-544-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZENI",
        "first_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LS12335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tariq A Khan, M.D.
• Smriti Khandelwal, M. S. CCC-SLP
• Marjan Kalhori Khanjan, PSYD
• Sedigheh Khatami, DDS
• Eric Khau, MD
• Khoi Binh Nguyen Dental Corporation
• Christina Khouie, M.A.
• James Kilgore
• Lakshmi Keerthana Killampalli
• Monique Kim-Nomura

• Clinical Social Worker in Tustin, CA
• Providers in Tustin, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.