Self

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

LCS 20834 Issued in CA

Legal business name

SELF

Practice address

10136 Amigo Ave
Northridge, CA 91324-1301

Phone

(818) 263-7904

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Maria Nieves Ornelas

Title

LCSW

Phone

(818) 263-7904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1699019786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10136 AMIGO AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10136 AMIGO AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241301",
            "telephone_number": "818-263-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "ORNELAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "NIEVES",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "818-263-7904"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "LCS 20834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Seddigh Tonekaboni, M.D.
• Tamim Sediq
• Davit Sedrakyan
• Beth L. Segel, PH.D.
• Jose Segura
• Alexander Seliverstov, M.D.
• Paul Jay Selski, D.D.S.
• Hooshang Semnani, M.D.
• Gari Alden Senderoff II
• Seniorcare at Northridge

• Health Maintenance Organization in Northridge, CA
• Providers in Northridge, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.