Individual provider Active NPI

Zubin S Zehtab, PMHNP-BC, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1699369579
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95016069 Issued in CA
Practice address
1560 E Chevy Chase Dr Ste 130
Glendale, CA 91206-4140
Phone
(818) 240-0340
NPI assigned
Feb 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F12200387 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95016069 CA Primary

Addresses

Primary practice location

1560 E Chevy Chase Dr Ste 130
Glendale, CA 91206-4140

Mailing address

1560 E Chevy Chase Dr Ste 130
Glendale, CA 91206-4140

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001634 CA Practitioner - Nurse Practitioner 8628420700 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

1560 E Chevy Chase Dr
Suite 130
Glendale, CA 91206-4140
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F12200387CAMDFamily Nurse Practitioner
95016069CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Aug 12, 2024 Accepting new patients
Comprehensive Hospitalist & Ambulatory Physicians-Hospitalists CurrentSince Nov 21, 2023 Accepting new patients
Penciu Medical Apmc CurrentSince Nov 12, 2025 Accepting new patients

Locations

1560 E Chevy Chase Dr
Ste 130
Glendale, CA 91206
Phone (818) 240-0340

1111 N Brand Blvd
Ste 312
Glendale, CA 91202
Phone (323) 230-0017

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

5000 Van Nuys Blvd
Ste 201
Sherman Oaks, CA 91403
Phone (818) 572-1490

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.zubinzehtab@143255.advancedmd-direct.com

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": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1699369579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E CHEVY CHASE DR STE 130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E CHEVY CHASE DR STE 130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064140",
            "telephone_number": "818-240-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEHTAB",
        "first_name": "ZUBIN",
        "middle_name": "S",
        "credential": "PMHNP-BC, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F12200387",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95016069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.