Pegah Heidari, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

77504 Issued in CA

Practice address

3125 Myers St
Riverside, CA 92503-5527

Phone

(951) 358-6858

NPI assigned

Dec 18, 2014

Last updated

May 28, 2015By 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 2

Addresses

Other names 1

• Pegah Jennifer Heidari Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1609274976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CAPISTRANO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926022421",
            "telephone_number": "949-300-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 MYERS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035527",
            "telephone_number": "951-358-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDARI",
        "first_name": "PEGAH",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77504",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGAH",
            "last_name": "HEIDARI",
            "middle_name": "JENNIFER",
            "credential": "MA, MFTI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marcie Hebreo
• Hagit Hecht, MD
• Dorothy Louise Heckman, CHIROPRACTOR
• Jennifer Heers
• Abigail Heffernan
• Matthew Ernest Heidl
• Solomon Jacob Heifets
• Joseph Heilmann
• Ava Cecile Hein, PA
• Melissa Heine

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.