Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

GHOLAMREZA ATAOLLAHETABRIZI
NPI 1770492662
Nurse Practitioner - Psychiatric/Mental Health in Porter Ranch, CA

Q: What is Gholamreza Ataollahetabrizi's NPI number?

The NPI number for Gholamreza Ataollahetabrizi is 1770492662. It was assigned to this individual provider in the NPPES registry on September 4, 2026.

Q: What is Gholamreza Ataollahetabrizi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since September 04, 2026

19377 GERMAIN ST, PORTER RANCH, CA 91326(949) 300-6713 Get Directions Write a Review

NPPES record added: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Gholamreza Ataollahetabrizi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GHOLAMREZA ATAOLLAHETABRIZI (NPI 1770492662) is an individual psychiatric/mental health provider in Porter Ranch, California, licensed in California (95041250) and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1770492662

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameGHOLAMREZA ATAOLLAHETABRIZI

Location Address19377 GERMAIN STPorter Ranch, CA 91326-2955

Mailing Address19377 Germain StPorter Ranch, CA 91326-2955 · (949) 300-6713

Phone(949) 300-6713

Sole ProprietorYes

Enumeration DateSeptember 4, 2026

NPPES CertifiedSeptember 4, 2026

✔ NPI 1770492662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95041250

19377 GERMAIN ST, Porter Ranch, CA 91326

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gholamreza Ataollahetabrizi's NPI number?

The NPI number for Gholamreza Ataollahetabrizi is 1770492662. It was assigned to this individual provider in the NPPES registry on September 4, 2026.

Where is Gholamreza Ataollahetabrizi located?

Gholamreza Ataollahetabrizi practices at 19377 Germain St, Porter Ranch, CA 91326. The listed phone number is (949) 300-6713.

What is Gholamreza Ataollahetabrizi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Gholamreza Ataollahetabrizi was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.