Natasha Sholom Khazanov, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14917 Issued in CA

Practice address

529 Irving St
San Francisco, CA 94122-2599

Phone

(415) 665-4490

Fax

(415) 665-4490

NPI assigned

Jul 10, 2006

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

Enrolled in CA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790719755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MIRALOMA DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271643",
            "telephone_number": "415-665-4490",
            "fax_number": "415-665-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 IRVING ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222599",
            "telephone_number": "415-665-4490",
            "fax_number": "415-665-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZANOV",
        "first_name": "NATASHA",
        "middle_name": "SHOLOM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tala Khatcherian
• Sharan Jeet Khatra, PHARMD
• Simranjit Kaur Khatra, NP-C
• Shieva Camellia Khayam-Bashi, MD
• Amita R Khazanie, MD
• Satveet Khela, D.O.
• Badreddine Khelifi
• Polina Khersonskiy
• Irina Khidekel, M.D.
• Mahesh Mohan Khilnani, NP

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.