Individual provider Active NPI

Kamron Fariba, DO

  • Psychiatry Physician
  • Glendora, CA
National Provider Identifier
1407315864
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A22760 Issued in CA
Practice address
415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone
(269) 634-4676
NPI assigned
Mar 15, 2019
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34.016741 OH
Psychiatry Physician 2084P0800X 20A22760 CA Primary
Psychiatry Physician 2084P0800X U5397 TX
Psychiatry Physician 2084P0800X 036171913 IL
Psychiatry Physician 2084P0800X 18239 FL
Psychiatry Physician 2084P0800X 0548697 KS
Psychiatry Physician 2084P0800X DO91264 SC
Psychiatry Physician 2084P0800X 2023045462 MO
Psychiatry Physician 2084P0800X 202304562 MO

Addresses

Primary practice location

415 W Route 66 Ste 202
Glendora, CA 91740-4335

Mailing address

415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, CA, IL4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20230901001853 FL Practitioner - Psychiatry 2567825979
I20240319002160 TX Practitioner - Psychiatry 2567825979 Reassigns benefits to 4 organizations
I20240605003220 CA Practitioner - Psychiatry 2567825979 Reassigns benefits to 3 organizations
I20250410000993 IL Practitioner - Psychiatry 2567825979

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Jacob and Associates IncGroup PAC ID 8224547831, 9 clinicians

Practice addresses (Care Compare)

151 Pioneer LN
Bishop, CA 93514-2557
Phone (760) 872-1000

415 W Route 66
Suite 202
Glendora, CA 91740-4335
Phone (626) 963-4467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20A22760CAMDPsychiatry Physician
18239FLMDPsychiatry Physician
036171913ILMDPsychiatry Physician
0548697KSMDPsychiatry Physician
202304562MOMDPsychiatry Physician
34.016741OHMDPsychiatry Physician
DO91264SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kamron a Fariba DO Inc Psychiatry CurrentSince Jul 29, 2024 Accepting new patients
Border Region MH Mr Community Center Psychiatry CurrentSince Apr 1, 2024 Accepting new patients
Burke Center Psychiatry CurrentSince Oct 1, 2024 Accepting new patients
Heart of Texas Region MHMR Center CurrentSince Mar 25, 2024 Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Mar 6, 2024 Accepting new patients
Texana Center CurrentSince Mar 7, 2024 Accepting new patients
Dr Jacob & Associates Inc Psychiatry CurrentSince Oct 1, 2025 Accepting new patients
Burke Center PastSince Oct 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

151 Pioneer Ln
Bishop, CA 93514
Phone (760) 872-1000

2705 S Diamond Bar Blvd
Ste 238
Diamond Bar, CA 91765
Phone (909) 860-2166

415 W Route 66
Ste 202
Glendora, CA 91740
Phone 6269634467202

1500 Pappas St
Laredo, TX 78041
Phone (956) 794-3000

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

601 N Frio St
#1
San Antonio, TX 78207
Phone (210) 225-5481

6800 Park Ten Blvd
Ste 200S
San Antonio, TX 78213
Phone 21026110001060

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1407315864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "269-634-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIBA",
        "first_name": "KAMRON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-15",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.016741",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A22760",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U5397",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036171913",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "18239",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0548697",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "DO91264",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2023045462",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "202304562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.