Active NPI
Mona Khaled
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1619691490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 94026928
- Practice address
- 1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013 - Phone
- (310) 453-8788
- NPI assigned
- Sep 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 94026928 | CA | Primary |
Addresses
Primary practice location
1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013
Mailing address
1250 Armorlite Dr Apt 111
San Marcos, CA 92069-1498
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
| License | State | Type | Specialty |
|---|---|---|---|
| 94026928 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1619691490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 ARMORLITE DR APT 111",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920691498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1849 SAWTELLE BLVD STE 610",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900257013",
"telephone_number": "310-453-8788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALED",
"first_name": "MONA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-27",
"last_updated": "2022-09-27",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "94026928",
"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 Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.