Azadeh Sofiya Azmoudeh

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

105096 Issued in CA

Practice address

29222 Rancho Viejo Rd
San Juan Capistrano, CA 92675

Phone

(949) 429-6888

NPI assigned

Dec 14, 2012

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

State licenses

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1780920066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 VIA LUCCA",
            "address_2": "APT # J241",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926120600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29222 RANCHO VIEJO RD",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "92675",
            "telephone_number": "949-429-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZMOUDEH",
        "first_name": "AZADEH",
        "middle_name": "SOFIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "105096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.