Panthea Razavi

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT146475 Issued in CA

Practice address

202 Providence Mine Rd Ste 105
Nevada City, CA 95959-2945

Phone

(530) 277-2046

NPI assigned

Mar 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kindred Heart Therapy Group Nonprofit

  • Marriage & Family Therapist
  • Nevada City, CA
  • NPI 1720689565
  Medicare reassignment NPD

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1891320131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5653",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635653",
            "telephone_number": "949-342-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PROVIDENCE MINE RD STE 105",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592945",
            "telephone_number": "530-277-2046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 N Tustin St Unit 5653",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "92863",
            "country_code": "US",
            "telephone_number": "949-342-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZAVI",
        "first_name": "PANTHEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT146475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ugo Punteri
• Julie Quillen
• Jeanne Renee Racik
• Tunisia Rader
• Joan Mary Ramsey, LCSW MFT
• Yvonne M Read, NP
• Deanna Reardon, PSY.D.
• Allison Leigh Rees, LMFT
• Joanna L. Reichhold, LMFT
• Terry Lana Renfroe, RDH

• Marriage & Family Therapist in Nevada City, CA
• Providers in Nevada City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.