Active NPI
Imran Khan, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Spring Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95025725
- Practice address
- 8788 Jamacha Rd
Spring Valley, CA 91977-4035 - Phone
- (619) 515-2385
- Fax
- (619) 589-2812
- NPI assigned
- Oct 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 707089 | NY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 404765 | NY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95025725 | CA | Primary |
Addresses
Primary practice location
8788 Jamacha Rd
Spring Valley, CA 91977-4035
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone (619) 515-2555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 707089 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Community Healthcare Network Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients |
Locations
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
8788 Jamacha Rd
Spring Valley, CA 91977
Phone (619) 515-2380
60 Madison Ave
Fl 5
New York, NY 10010
Phone (212) 545-2400
81 W 115th St
New York, NY 10026
Phone (212) 426-0088
44 W 28th St
Fl 5
New York, NY 10001
Phone (212) 545-2439
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1235521782
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
-
- Federally Qualified Health Center (FQHC)
- Spring Valley, CA
- NPI 1508801069
-
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1316014103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1801267828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-515-2300",
"fax_number": "619-589-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8788 JAMACHA RD",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919774035",
"telephone_number": "619-515-2385",
"fax_number": "619-589-2812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "IMRAN",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-16",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "707089",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "404765",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95025725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spring Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.