Individual provider Active NPI

Maryam Dehbozorgi, FNP

  • Family Nurse Practitioner
  • Upland, CA
National Provider Identifier
1922954080
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95038710 Issued in CA
Practice address
1183 E Foothill Blvd Ste 135
Upland, CA 91786-4082
Phone
(909) 931-1368
NPI assigned
Mar 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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 95038710 CA Primary

Addresses

Primary practice location

1183 E Foothill Blvd Ste 135
Upland, CA 91786-4082

Mailing address

1183 E Foothill Blvd Ste 135
Upland, CA 91786-4082

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
95038710CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1922954080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD STE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD STE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864082",
            "telephone_number": "909-931-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHBOZORGI",
        "first_name": "MARYAM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95038710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.