Individual provider Active NPI

Stella Nazarpoor, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1770148058
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95010942 Issued in CA
Practice address
800 S Victory Blvd Ste 106
Burbank, CA 91502-2489
Phone
(818) 860-0133
Fax
(818) 860-0134
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95010942 CA Primary

Addresses

Primary practice location

800 S Victory Blvd Ste 106
Burbank, CA 91502-2489

Mailing address

15621 Odyssey Dr
Unit 37
Granada Hills, CA 91344-3282
Phone (818) 404-4230

Other practice location 1

222 W Eulalia St Ste 301
Glendale, CA 91204-2851
Phone (818) 240-0108

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL granadahills Direct

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
I20200327001584 CA Practitioner - Nurse Practitioner 7911336813 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010942CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Aug 15, 2022 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Aug 15, 2022 Accepting new patients

Locations

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

1529 E Palmdale Blvd
Ste 150
Palmdale, CA 93550
Phone (661) 575-1800

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1770148058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15621 ODYSSEY DR",
            "address_2": "UNIT 37",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443282",
            "telephone_number": "818-404-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S VICTORY BLVD STE 106",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022489",
            "telephone_number": "818-860-0133",
            "fax_number": "818-860-0134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W Eulalia St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912042851",
            "country_code": "US",
            "telephone_number": "818-240-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZARPOOR",
        "first_name": "STELLA",
        "credential": "MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95010942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "granadahills",
            "affiliation": "N",
            "endpointDescription": "psychnotes",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "granadahills",
            "address_1": "222 W Eulalia St Ste 301",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912042851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.