Individual provider Active NPI

Julian Saddi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cerritos, CA
National Provider Identifier
1619667011
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95023894 Issued in CA
Practice address
17100 Norwalk Blvd. Ste 110
Cerritos, CA 90703
Phone
(323) 230-0634
NPI assigned
May 9, 2023
Reactivated
Jul 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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 95023894 CA Primary

Addresses

Primary practice location

17100 Norwalk Blvd. Ste 110
Cerritos, CA 90703

Mailing address

17100 Norwalk Blvd. Ste 110 #724
Cerritos, CA 90703
Phone (323) 230-0634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607000092 CA Practitioner - Nurse Practitioner 0941667927

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Hospice Group Inc PastSince Jul 21, 2024 Accepting new patients

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1619667011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 NORWALK BLVD. STE 110 #724",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "90703",
            "telephone_number": "323-230-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 NORWALK BLVD. STE 110",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "90703",
            "telephone_number": "323-230-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDI",
        "first_name": "JULIAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "deactivation_date": "2024-03-21",
        "reactivation_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.