Jennifer Fard

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

104661 Issued in CA

Practice address

23041 Avenida de la Carlota
Laguna Hills, CA 92653-1511

Phone

(949) 229-1463

NPI assigned

Nov 18, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ocean Breeze Behavioral Therapy Inc

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1427897503
  NPD Authorized official
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  NPD

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1255633517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 PACIFIC COAST HWY # 191",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406214",
            "telephone_number": "949-229-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23041 AVENIDA DE LA CARLOTA",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531511",
            "telephone_number": "949-229-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARD",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Care Quality",
            "affiliationName": "Kaiser Permanente Southern Californa Orange County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "23041 Avenida De La Carlota",
            "city": "Laguna Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926531511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Angela Fajardo, D.O.
• Richard D Fan, PA
• Kaveh Faramarzi
• Mishel Farasatpour, MD
• Farbod Farmand DO a Professional Corp
• Mahshid Farhoumand, D.D.S.
• Farjoudi Medical Corporation
• Daniel Joseph Farkas, D.C.
• Fartash Farkhondehkish, D.D.S., M.S.
• Farbod Farmand, D.O

• Marriage & Family Therapist in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.