Individual provider Active NPI

Shahrzad Mahmoudi

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1588200224
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
116252 Issued in CA
Practice address
691 Irolo St Apt 1408
Los Angeles, CA 90005-4118
Phone
(619) 884-3766
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 116252 CA Primary

Addresses

Primary practice location

691 Irolo St Apt 1408
Los Angeles, CA 90005-4118

Mailing address

691 Irolo St Apt 1408
Los Angeles, CA 90005-4118
Phone (619) 884-3766

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

State licenses

LicenseStateTypeSpecialty
116252CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1588200224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 IROLO ST APT 1408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054118",
            "telephone_number": "619-884-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 IROLO ST APT 1408",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054118",
            "telephone_number": "619-884-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUDI",
        "first_name": "SHAHRZAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "116252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.