Individual provider Active NPI

Bita Ghafoori, PH.D.

  • Clinical Psychologist
  • Long Beach, CA
National Provider Identifier
1356414635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY18815 Issued in CA
Practice address
1250 N Bellflower Blvd
Csulb- Edpac Dept
Long Beach, CA 90840-2201
Phone
(562) 985-7864
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY18815 CA Primary

Addresses

Primary practice location

1250 N Bellflower Blvd
Csulb- Edpac Dept
Long Beach, CA 90840-2201

Mailing address

1250 N Bellflower Blvd
Csulb- Edpac Dept
Long Beach, CA 90840-2201
Phone (562) 985-7864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY18815CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356414635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "address_2": "CSULB- EDPAC DEPT",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908402201",
            "telephone_number": "562-985-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "address_2": "CSULB- EDPAC DEPT",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908402201",
            "telephone_number": "562-985-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAFOORI",
        "first_name": "BITA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.