Individual provider Active NPI

Treza Mirakhor, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1730553629
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
90000 Issued in CA
Practice address
1226 S Shenandoah St Apt 202
Los Angeles, CA 90035-2271
Phone
(310) 691-0049
NPI assigned
Nov 16, 2015
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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 90000 CA Primary

Addresses

Primary practice location

1226 S Shenandoah St Apt 202
Los Angeles, CA 90035-2271

Mailing address

2001 S Barrington Ave Ste 204
Los Angeles, CA 90025-5385
Phone (310) 691-0049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90000CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1730553629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255385",
            "telephone_number": "310-691-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 S SHENANDOAH ST APT 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352271",
            "telephone_number": "310-691-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAKHOR",
        "first_name": "TREZA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "90000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.