Individual provider Active NPI

Mitra Rajabi, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1710674106
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024823 Issued in CA
Practice address
955 Carrillo Dr Ste 300
Los Angeles, CA 90048-5475
Phone
(424) 258-0124
NPI assigned
Apr 18, 2023
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024823 CA Primary

Addresses

Primary practice location

955 Carrillo Dr Ste 300
Los Angeles, CA 90048-5475

Mailing address

955 Carrillo Dr Ste 300
Los Angeles, CA 90048-5475
Phone (424) 258-0124

Other names 1

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250512001367 CA Practitioner - Nurse Practitioner 5890212906 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95024823CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ghods Inc CurrentSince Mar 2, 2025 Accepting new patients

Locations

1086 S Fairfax Ave
Los Angeles, CA 90019
Phone (424) 258-0124

955 Carrillo Dr
Ste 300
Los Angeles, CA 90048
Phone (424) 258-0124

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1710674106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485475",
            "telephone_number": "424-258-0124",
            "fax_number": "310-602-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485475",
            "telephone_number": "424-258-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJABI",
        "first_name": "MITRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITRA",
            "last_name": "ENDERS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.