Individual provider Active NPI

Faramarz Shahinpouri, LCSW

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1285963249
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
78852 Issued in CA
Practice address
10800 Hole Ave Ste 4
Riverside, CA 92505-2759
Phone
(951) 588-8838
Fax
(951) 351-2722
NPI assigned
Dec 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 658-M AR
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 78852 CA Primary

Addresses

Primary practice location

10800 Hole Ave Ste 4
Riverside, CA 92505-2759

Mailing address

La Sierra Counseling
10800 Hole Ave., Suit 4
Riverside, CA 92505-2578
Phone (951) 588-8838

Other identifiers 1

IdentifierTypeStateIssuer
658-MOtherARLMSW

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
I20240910000708 CA Practitioner - Clinical Social Worker 1850831496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910
Phone (442) 327-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
658-MARMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Clinical CurrentSince Jul 30, 2024 Accepting new patients
Julio Grova Single Specialty PastSince Sep 23, 2021 Accepting new patients
Coast to Coast Psychological Services Clinical Past Accepting new patients

Locations

3610 Central Ave
Ste 500
Riverside, CA 92506
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

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": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1285963249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LA SIERRA COUNSELING",
            "address_2": "10800 HOLE AVE., SUIT 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052578",
            "telephone_number": "951-588-8838",
            "fax_number": "951-351-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 HOLE AVE STE 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052759",
            "telephone_number": "951-588-8838",
            "fax_number": "951-351-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHINPOURI",
        "first_name": "FARAMARZ",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-21",
        "last_updated": "2021-09-17",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "658-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "658-M",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.