Individual provider Active NPI

Donna Vafa Kashani, M.D.

  • Child & Adolescent Psychiatry Physician
  • La Jolla, CA
National Provider Identifier
1659459790
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
G88012 Issued in CA
Practice address
4225 Executive SQ Ste 600
La Jolla, CA 92037-1484
Phone
(858) 776-6267
Fax
(858) 367-8306
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X G88012 CA Primary

Addresses

Primary practice location

4225 Executive SQ Ste 600
La Jolla, CA 92037-1484

Mailing address

4225 Executive SQ Ste 600
La Jolla, CA 92037-1484
Phone (858) 776-6267

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G88012CAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1659459790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 600",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371484",
            "telephone_number": "858-776-6267",
            "fax_number": "858-367-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 600",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371484",
            "telephone_number": "858-776-6267",
            "fax_number": "858-367-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHANI",
        "first_name": "DONNA",
        "middle_name": "VAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G88012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.