Soudeh Khayam-Bashi, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95057258 Issued in CA

Practice address

4237 Longridge Ave Unit 103
Studio City, CA 91604-1876

Phone

(818) 268-7089

NPI assigned

Feb 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1740935303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 LONGRIDGE AVE UNIT 103",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041876",
            "telephone_number": "818-268-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 LONGRIDGE AVE UNIT 103",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041876",
            "telephone_number": "818-268-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYAM-BASHI",
        "first_name": "SOUDEH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95057258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Kelly
• Kevork Keyo, DDS
• Daniel Keyvani, DDS
• Sona Khachunts, PHARMD
• Sherry Khadavi, PHARM.D.
• Pargol Khoshnoud
• Kiarash Paydar, M.D. Inc
• Charles Kim
• Heidi Kim, LCSW
• Vivian Kim

• Acute Care Nurse Practitioner in Studio City, CA
• Providers in Studio City, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.