Individual provider Active NPI

Negar Nazari

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1063854099
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30769 Issued in CA
Practice address
5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786
Phone
(619) 483-1427
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY30769 CA Primary

Addresses

Primary practice location

5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786

Mailing address

5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786

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

LicenseStateTypeSpecialty
PSY30769CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Negar Nazari PHD Psychologist Inc CurrentSince Feb 7, 2019 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients

Locations

3636 4th Ave
Ste 304
San Diego, CA 92103
Phone (760) 799-1000

5405 Morehouse Dr
Ste 330
San Diego, CA 92121
Phone (619) 880-9008

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1063854099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 MOREHOUSE DR STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 MOREHOUSE DR STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214786",
            "telephone_number": "619-483-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARI",
        "first_name": "NEGAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.