Individual provider Active NPI

Mehrangiz Rajabi Lundquist, PHD

  • Psychiatry Physician
  • Newport Beach, CA
National Provider Identifier
1275697765
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
PSY14618 Issued in CA
Practice address
200 Newport Center Dr
Suite 305
Newport Beach, CA 92660-7504
Phone
(949) 640-8200
Fax
(949) 640-8200
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X PSY14618 CA Primary

Addresses

Primary practice location

200 Newport Center Dr
Suite 305
Newport Beach, CA 92660-7504

Mailing address

200 Newport Center Dr
Suite 305
Newport Beach, CA 92660-7501
Phone (949) 640-8200

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
I20050302001084 CA Practitioner - Clinical Psychologist 0446203301 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Newport Ctr Dr
Suite 305
Newport Beach, CA 92660-7504
Phone (949) 640-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY14618CAMDPsychiatry Physician
14618CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1275697765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "SUITE 305",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "949-640-8200",
            "fax_number": "949-640-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "SUITE 305",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607504",
            "telephone_number": "949-640-8200",
            "fax_number": "949-640-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "MEHRANGIZ",
        "middle_name": "RAJABI",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "PSY14618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.