Individual provider Active NPI

Farhad Khorrami Yaghoubi, M.D.

  • Child & Adolescent Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1376619221
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A76463 Issued in CA
Practice address
2600 Redondo Ave FL 6
Long Beach, CA 90806-2325
Phone
(562) 256-2906
Fax
(562) 290-0136
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A76463 CA Primary

Addresses

Primary practice location

2600 Redondo Ave FL 6
Long Beach, CA 90806-2325

Mailing address

2600 Redondo Ave FL 6
Long Beach, CA 90806-2325
Phone (562) 256-2906

Other practice location 1

240 E. 20th St.
Long Beach, CA 90806
Phone (562) 599-9271

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76463CAMDClinical Social Worker
A76463CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Guidance Center Past Accepting new patients

Organizations & group practices 1

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1376619221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE FL 6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2906",
            "fax_number": "562-290-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE FL 6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2906",
            "fax_number": "562-290-0136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E. 20th St.",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "90806",
            "country_code": "US",
            "telephone_number": "562-599-9271",
            "fax_number": "562-218-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGHOUBI",
        "first_name": "FARHAD",
        "middle_name": "KHORRAMI",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A76463",
            "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 Mar 15, 2021; 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.