Individual provider Active NPI

Imran Khan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spring Valley, CA
National Provider Identifier
1801267828
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025725 Issued in CA
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

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240221004108 NY Practitioner - Nurse Practitioner 0143664763
I20241111001608 CA Practitioner - Nurse Practitioner 0143664763 Reassigns benefits to 1 organization

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
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

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

LicenseStateTypeSpecialty
707089NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew 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 CurrentSince Nov 11, 2024 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Nov 11, 2024 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.

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

Verify at the official NPI Registry.