Mahmood Ketabchi, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

106345 Issued in CA

Practice address

3700 Delta Fair Blvd Ste 202
Antioch, CA 94509-4074

Phone

(510) 697-8290

NPI assigned

Jun 16, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1679987887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 CAMBRIDGE DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096447",
            "telephone_number": "510-697-8290",
            "fax_number": "925-848-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 DELTA FAIR BLVD STE 202",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094074",
            "telephone_number": "510-697-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETABCHI",
        "first_name": "MAHMOOD",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kechi Supported Living, Inc
• Nichelle Keffler-Roa, DPT
• Serena Lachelle Kelly
• Valerie Kemp
• Robert Ford Kennedy
• Farooq Ha Khan, D.D.S.
• Madiha Batool Khan, MD
• Nadir Khan, M.D.
• Sana Siddiqui Khan, M.D.
• Sommaiya Khan, IBCLC

• Marriage & Family Therapist in Antioch, CA
• Providers in Antioch, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.