Healthcare Provider Details

I. General information

NPI: 1902224421
Provider Name (Legal Business Name): MAHSA MINAGAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 S TREMONT ST
OCEANSIDE CA
92054-5309
US

IV. Provider business mailing address

4470 SUNSET BLVD STE 107 PMB94731
LOS ANGELES CA
90027-6309
US

V. Phone/Fax

Practice location:
  • Phone: 760-439-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number78804
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017600
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: