Individual provider Active NPI

Aidin Tajbakhsh

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1265985758
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364
Phone
(858) 695-2211
NPI assigned
Aug 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364

Mailing address

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364

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
I20250328002475 CA Practitioner - Clinical Psychologist 9335662485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4631 Teller Ave
Suite 100
Newport Beach, CA 92660-8105
Phone (949) 887-7187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34527CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Psychiatry & Mental Health, Professional Corporation CurrentSince Jan 20, 2025 Accepting new patients
Community Research Foundation Inc PastSince Sep 12, 2021 Accepting new patients
Community Research Foundation Inc PastSince Sep 12, 2021 Accepting new patients

Locations

4631 Teller Ave
Ste 100
Newport Beach, CA 92660
Phone (949) 335-7500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1265985758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262364",
            "telephone_number": "858-695-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJBAKHSH",
        "first_name": "AIDIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.