Individual provider Active NPI

Narges Mohsenpour, PSYD, MA

  • Psychologist
  • Seaside, CA
National Provider Identifier
1861825416
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1069 Broadway Ave Ste 201
Seaside, CA 93955-4995
Phone
(831) 392-1500
NPI assigned
Aug 19, 2013
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Psychologist 103T00000X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1069 Broadway Ave Ste 201
Seaside, CA 93955-4995

Mailing address

1069 Broadway Ave Ste 201
Seaside, CA 93955-4995
Phone (831) 392-1500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260611004364 CA Practitioner - Clinical Psychologist 4587136452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

11835 W Olympic Blvd
Suite 1270E
Los Angeles, CA 90064-5053
Phone (310) 273-4843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Mental Health, Inc. Mental Health CurrentSince Jun 1, 2026 Accepting new patients
The Village Project, Incorporated PastSince May 21, 2023 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1861825416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 BROADWAY AVE STE 201",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939554995",
            "telephone_number": "831-392-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 BROADWAY AVE STE 201",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939554995",
            "telephone_number": "831-392-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSENPOUR",
        "first_name": "NARGES",
        "name_prefix": "Miss",
        "credential": "PSYD, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaside, CA

Sources for this page

Verify at the official NPI Registry.