Azadeh Khamooshi, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

94028153 Issued in CA

Practice address

17702 Sierra Hwy
Santa Clarita, CA 91351-1635

Phone

(888) 770-5222

NPI assigned

Jun 1, 2022

Last updated

Jul 28, 2026By 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 1

Addresses

Other names 1

• Ava Khamooshi Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pure Autism Counseling Center Inc

  dba Pacc Mental Health Services

  • Community/Behavioral Health Agency
  • Santa Clarita, CA
  • NPI 1649737735

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1629717277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL # 2073",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "619-212-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17702 SIERRA HWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913511635",
            "telephone_number": "888-770-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMOOSHI",
        "first_name": "AZADEH",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "94028153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVA",
            "last_name": "KHAMOOSHI",
            "credential": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Psychologist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.