Individual provider Active NPI

Samira Rastegar

  • School Psychologist
  • Walnut Creek, CA
National Provider Identifier
1417849035
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
2879 Issued in CA
Practice address
1415 Oakland Blvd Ste 203
Walnut Creek, CA 94596-4395
Phone
(925) 940-5576
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 2879 CA Primary

Addresses

Primary practice location

1415 Oakland Blvd Ste 203
Walnut Creek, CA 94596-4395

Mailing address

1415 Oakland Blvd Ste 203
Walnut Creek, CA 94596-4395
Phone (925) 378-9456

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

Practice roles

OrganizationSpecialtyStatusNew patients
Theratree Community: Child & Family Counseling Inc. CurrentSince Jul 22, 2025 Accepting new patients

Locations

1415 Oakland Blvd
Ste 203
Walnut Creek, CA 94596
Phone (925) 378-9456

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1417849035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 OAKLAND BLVD STE 203",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964395",
            "telephone_number": "925-378-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 OAKLAND BLVD STE 203",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964395",
            "telephone_number": "925-940-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASTEGAR",
        "first_name": "SAMIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "2879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.