Individual provider Active NPI

Bahar Safaei-Far, PSY.D.

  • Clinical Psychologist
  • Tarzana, CA
National Provider Identifier
1396961512
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20208 Issued in CA
Practice address
18757 Burbank Blvd
Suite 125
Tarzana, CA 91356-3375
Phone
(818) 963-1338
Fax
(818) 527-1339
NPI assigned
Apr 17, 2007
Last updated
Apr 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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 20208 CA Primary

Addresses

Primary practice location

18757 Burbank Blvd
Suite 125
Tarzana, CA 91356-3375

Mailing address

18757 Burbank Blvd
Suite 125
Tarzana, CA 91356-3375
Phone (818) 963-1338

Other identifiers 1

IdentifierTypeStateIssuer
20208OtherCAPSYD LICENSE NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark John Souris Clinical 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1396961512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18757 BURBANK BLVD",
            "address_2": "SUITE 125",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563375",
            "telephone_number": "818-963-1338",
            "fax_number": "818-527-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18757 BURBANK BLVD",
            "address_2": "SUITE 125",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563375",
            "telephone_number": "818-963-1338",
            "fax_number": "818-527-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAEI-FAR",
        "first_name": "BAHAR",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYD LICENSE NUMBER",
            "identifier": "20208",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.