Active NPI
Kobra Schabanpour
- Clinical Social Worker
- Glendale, CA
National Provider Identifier
1699160119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 65677
- Practice address
- 1505 Wilson Ter Ste 190
Glendale, CA 91206-4015 - Phone
- (310) 561-9571
- Fax
- (818) 637-8354
- NPI assigned
- Apr 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 65677 | CA | Primary |
Addresses
Primary practice location
1505 Wilson Ter Ste 190
Glendale, CA 91206-4015
Mailing address
230N Maryland Ave 303
Glendale, CA 91206-4281
Phone (310) 561-9571
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230705001683 | CA | Practitioner - Clinical Social Worker | 7719235134 | Practice locations: Glendale, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720051200000",
"number": "1699160119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230N MARYLAND AVE 303",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064281",
"telephone_number": "310-561-9571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 WILSON TER STE 190",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064015",
"telephone_number": "310-561-9571",
"fax_number": "818-637-8354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHABANPOUR",
"first_name": "KOBRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-01",
"last_updated": "2024-07-04",
"certification_date": "2024-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "65677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.