Individual provider Active NPI

Shakiba Peyrovi, FNP-C

  • Family Nurse Practitioner
  • Lake Forest, CA
National Provider Identifier
1609706266
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95039669 Issued in CA
Practice address
23672 Birtcher Dr
Lake Forest, CA 92630-1711
Phone
(949) 770-7301
NPI assigned
May 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 95039669 CA Primary

Addresses

Primary practice location

23672 Birtcher Dr
Lake Forest, CA 92630-1711

Mailing address

1539 Caribbean Way
Laguna Beach, CA 92651-1907
Phone (949) 400-7535

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
95039669CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1609706266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 CARIBBEAN WAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511907",
            "telephone_number": "949-400-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23672 BIRTCHER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301711",
            "telephone_number": "949-770-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYROVI",
        "first_name": "SHAKIBA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95039669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; 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.