Active NPI
Mastaneh G. Moghadam, LCSW
- Clinical Social Worker
- North Hollywood, CA
National Provider Identifier
1952339871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS23095
- Practice address
- 12821 Victory Blvd
North Hollywood, CA 91606-3012 - Phone
- (818) 432-5037
- NPI assigned
- Jun 29, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS23095 | CA | Primary |
Addresses
Primary practice location
12821 Victory Blvd
North Hollywood, CA 91606-3012
Mailing address
3642 Scadlock LN
Sherman Oaks, CA 91403-4318
Phone (818) 933-1148
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS23095 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1952339871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3642 SCADLOCK LN",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914034318",
"telephone_number": "818-933-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12821 VICTORY BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063012",
"telephone_number": "818-432-5037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADAM",
"first_name": "MASTANEH",
"middle_name": "G.",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS23095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.