Individual provider Active NPI

Azeen Nafisi, PSYD, LP

  • Clinical Psychologist
  • Burbank, CA
National Provider Identifier
1235625211
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34508 Issued in CA
Practice address
191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone
(925) 282-1778
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 34508 CA Primary
Rehabilitation Counselor 225C00000X

Addresses

Primary practice location

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556

Mailing address

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone (925) 282-1778

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
I20231018002349 CA Practitioner - Clinical Psychologist 6204281751 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34508CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Scott Psychologist Corp Clinical CurrentSince Oct 19, 2023 Accepting new patients

Locations

4605 Lankershim Blvd
Ste 545
North Hollywood, CA 91602
Phone (323) 999-1395

7720 Painter Ave
Ste C
Whittier, CA 90602
Phone (323) 999-1395

Organizations & group practices 2

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1235625211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAFISI",
        "first_name": "AZEEN",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34508",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.