Individual provider Active NPI

Anahita Shahbazi, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1851055735
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
124201 Issued in CA
Practice address
7665 Palmilla Dr Apt 5207
San Diego, CA 92122-5032
Phone
(619) 630-9453
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 124201 CA Primary

Addresses

Primary practice location

7665 Palmilla Dr Apt 5207
San Diego, CA 92122-5032

Mailing address

PO Box 262011
San Diego, CA 92196-2011
Phone (619) 630-9453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124201CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mindfulness Therapy Marriage & Family Therapist CurrentSince Jul 21, 2024 Accepting new patients
Shine Medical of Ca PC Multi-Specialty Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1851055735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262011",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921962011",
            "telephone_number": "619-630-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7665 PALMILLA DR APT 5207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225032",
            "telephone_number": "619-630-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBAZI",
        "first_name": "ANAHITA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.