Active NPI
Arezou M. Costello, PH.D.
- Psychologist
- Long Beach, CA
National Provider Identifier
1891264222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 30470
- Practice address
- 5901 E 7TH St
Long Beach, CA 90822-5201 - Phone
- (562) 826-8000
- NPI assigned
- Nov 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 30470 | CA | Primary |
Addresses
Primary practice location
5901 E 7TH St
Long Beach, CA 90822-5201
Mailing address
5901 E 7TH St
Long Beach, CA 90822-5201
Other names 1
- Dr. Arezou Mortazavi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 13, 2024 through Aug 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30470 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Counseling a Marriage and Family Therapy Corporation | Past | 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.
-
- Marriage & Family Therapist
- Berkeley, CA
- NPI 1902314297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542153600000",
"number": "1891264222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201",
"telephone_number": "562-826-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "AREZOU",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2018-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "30470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AREZOU",
"last_name": "MORTAZAVI",
"prefix": "DR.",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.