Active NPI
Ida Fariba
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1538703657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 3333 Camino del Rio S Ste 215
San Diego, CA 92108-3837 - Phone
- (619) 558-0001
- NPI assigned
- Oct 31, 2019
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
3333 Camino del Rio S Ste 215
San Diego, CA 92108-3837
Mailing address
8228 Cichlid Way
San Diego, CA 92129-3776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 6, 2024 through Mar 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124097 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1538703657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8228 CICHLID WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921293776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 CAMINO DEL RIO S STE 215",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083837",
"telephone_number": "619-558-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARIBA",
"first_name": "IDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.