Individual provider Active NPI

Baharak Farzanmehr, LCSW

  • Clinical Social Worker
  • Costa Mesa, CA
National Provider Identifier
1063203214
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
130156 Issued in CA
Practice address
3400 Avenue of the Arts
Costa Mesa, CA 92626-1927
Phone
(171) 436-5689
NPI assigned
May 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 130156 CA Primary

Addresses

Primary practice location

3400 Avenue of the Arts
Costa Mesa, CA 92626-1927

Mailing address

3400 Avenue of the Arts
Costa Mesa, CA 92626-1927
Phone (171) 436-5689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205001047 CA Practitioner - Clinical Social Worker 7315430584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2810 Brentwood Dr
Bay Minette, AL 36507-6210

4110 Edison Ave
Suite 206a
Chino, CA 91710-8417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Health Management Psychological Corporation CurrentSince Nov 20, 2025 Accepting new patients

Locations

4110 Edison Ave
Ste 206A
Chino, CA 91710
Phone (951) 454-5577

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1063203214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 AVENUE OF THE ARTS",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261927",
            "telephone_number": "171-436-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 AVENUE OF THE ARTS",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261927",
            "telephone_number": "171-436-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARZANMEHR",
        "first_name": "BAHARAK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "130156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.