Neda Khodaparast, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23114 Issued in CA

Practice address

5252 Balboa Ave
Suite 204
San Diego, CA 92117-6906

Phone

(858) 480-9118

Fax

(858) 712-9035

NPI assigned

Jul 7, 2008

Last updated

Jan 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Green Room Psychology Services Incorporation

  • Specialist
  • San Diego, CA
  • NPI 1811263957
  Authorized official Same address or phone

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1255594677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176906",
            "telephone_number": "858-480-9118",
            "fax_number": "858-712-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176906",
            "telephone_number": "858-480-9118",
            "fax_number": "858-712-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAPARAST",
        "first_name": "NEDA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Thao Khieu
• Cindy Khine
• Sheetal Khiyani, M.D.
• Swapnil Khoche
• Elmira Khodapanah, D.D.S
• Jennifer Lin Khoe, M.D.
• Melanie Christine Khoe, NONE
• Tatyana Kholodkov
• Mariya Nikolayevna Kholodova, PH.D.
• Lizaveta Khomich

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.