Individual provider Active NPI

Brynna Simin Farbod

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1144080649
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
325 W Vernon Ave
Phoenix, AZ 85003-1040
Phone
(480) 255-9947
NPI assigned
Mar 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

325 W Vernon Ave
Phoenix, AZ 85003-1040

Mailing address

325 W Vernon Ave
Phoenix, AZ 85003-1040
Phone (480) 255-9947

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1144080649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W VERNON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031040",
            "telephone_number": "480-255-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W VERNON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031040",
            "telephone_number": "480-255-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBOD",
        "first_name": "BRYNNA",
        "middle_name": "SIMIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.