Individual provider Active NPI

Fariba Kermanshahi

  • Family Nurse Practitioner
  • West Hollywood, CA
National Provider Identifier
1881461739
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95027699 Issued in CA
Practice address
7111 Santa Monica Blvd Ste B176
West Hollywood, CA 90046-3445
Phone
(323) 688-8667
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95027699 CA Primary

Addresses

Primary practice location

7111 Santa Monica Blvd Ste B176
West Hollywood, CA 90046-3445

Mailing address

7111 Santa Monica Blvd Ste B176
West Hollywood, CA 90046-3445

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703004289 CA Order and Referring Only - Certified Clinical Nurse Specialist (CNS) 9931643640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP95027699CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1881461739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 SANTA MONICA BLVD STE B176",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900463445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 SANTA MONICA BLVD STE B176",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900463445",
            "telephone_number": "323-688-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMANSHAHI",
        "first_name": "FARIBA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95027699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.