Active NPI
Nazneen Bahrassa, PH.D.
- Psychologist
- Santa Rosa, CA
National Provider Identifier
1447674791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY - 1441
- Practice address
- 3841 Brickway Blvd
Santa Rosa, CA 95403-8226 - Phone
- (707) 569-2392
- NPI assigned
- Feb 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY - 1441 | HI | Primary |
Addresses
Primary practice location
3841 Brickway Blvd
Santa Rosa, CA 95403-8226
Mailing address
4150 Clement St
San Francisco, CA 94121-1545
Phone (707) 569-2392
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 16, 2024 through Jan 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY - 1441 | HI | MD | Psychologist |
| 26373 | CA | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1447674791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "707-569-2392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3841 BRICKWAY BLVD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038226",
"telephone_number": "707-569-2392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAHRASSA",
"first_name": "NAZNEEN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-06",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "HI",
"license": "PSY - 1441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.