MEDICARE: SOPHIA KHAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	AMFT157483	CA

General Provider Information

NPI Number	:	1699622613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA KHAN

Provider Business Mailing Address
First Line	:	11620 WILSHIRE BLVD STE 520
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1778
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11620 WILSHIRE BLVD STE 520
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1778
Country	:	US
Telephone Number	:	888-860-2825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ SOPHIA KHAN ” Practice Location

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