Individual provider Active NPI

Luma Muhtadie, PHD

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1689265928
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32035 Issued in CA
Practice address
845 El Camino Real
Menlo Park, CA 94025-4807
Phone
(650) 862-4574
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY32035 CA Primary

Addresses

Primary practice location

845 El Camino Real
Menlo Park, CA 94025-4807

Mailing address

2265 15TH St
San Francisco, CA 94114-1237
Phone (650) 862-4574

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PSY32035CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1689265928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 15TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141237",
            "telephone_number": "650-862-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254807",
            "telephone_number": "650-862-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHTADIE",
        "first_name": "LUMA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.