Individual provider Active NPI

Shifteh Azodi-Deylami, LMFT

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1699110239
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147082 Issued in CA
Practice address
2035 E Ball Rd
Anaheim, CA 92806-5159
Phone
(650) 279-6854
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 147082 CA Primary

Addresses

Primary practice location

2035 E Ball Rd
Anaheim, CA 92806-5159

Mailing address

34 Ericson Aisle
Irvine, CA 92620-5722
Phone (949) 973-6789

Other names 1

  • Ms. Shifteh Azodi-Deylami Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250515003220 CA Practitioner - Marriage and Family Therapist 3173041829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cyti Health PCGroup PAC ID 4587012950, 34 clinicians

Practice addresses (Care Compare)

3111 Camino del Rio N
Suite 460
San Diego, CA 92108-5720
Phone (866) 478-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147082CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Psychiatry & Mental Health, Professional Corporation CurrentSince Feb 2, 2025 Accepting new patients
Clicktalk Mental Health Counseling Marriage & Family Therapist CurrentSince Jun 16, 2024 Accepting new patients

Locations

4631 Teller Ave
Ste 100
Newport Beach, CA 92660
Phone (949) 335-7500

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1699110239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 ERICSON AISLE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926205722",
            "telephone_number": "949-973-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 E BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065159",
            "telephone_number": "650-279-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZODI-DEYLAMI",
        "first_name": "SHIFTEH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2024-06-10",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIFTEH",
            "last_name": "AZODI-DEYLAMI",
            "prefix": "MS.",
            "credential": "LMFT147082",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.