Individual provider Active NPI

Sanaz Derakhshani Jan

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1942961693
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
84552 Issued in CA
Practice address
4046 S Centinela Ave
Los Angeles, CA 90066-4907
Phone
(818) 913-9338
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84552 CA Primary

Addresses

Primary practice location

4046 S Centinela Ave
Los Angeles, CA 90066-4907

Mailing address

4046 S Centinela Ave
Los Angeles, CA 90066-4907

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
84552CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1942961693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 S CENTINELA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 S CENTINELA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664907",
            "telephone_number": "818-913-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAKHSHANI JAN",
        "first_name": "SANAZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.