Individual provider Active NPI

Sona Midourian

  • Marriage & Family Therapist
  • Granada Hills, CA
National Provider Identifier
1861151532
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
128528 Issued in CA
Practice address
11856 Balboa Blvd # 442
Granada Hills, CA 91344-2753
Phone
(818) 442-2472
Fax
(818) 471-4111
NPI assigned
Dec 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 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: 193400000X SINGLE SPECIALTY GROUP 106H00000X 128528 CA Primary

Addresses

Primary practice location

11856 Balboa Blvd # 442
Granada Hills, CA 91344-2753

Mailing address

11856 Balboa Blvd # 442
Granada Hills, CA 91344-2753
Phone (818) 442-2472

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
128528CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blooming Minds, Inc Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 1

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": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1861151532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11856 BALBOA BLVD # 442",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753",
            "telephone_number": "818-442-2472",
            "fax_number": "818-471-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11856 BALBOA BLVD # 442",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753",
            "telephone_number": "818-442-2472",
            "fax_number": "818-471-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDOURIAN",
        "first_name": "SONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

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