Individual provider Active NPI

Jennifer Love Farrell, M.D.

  • Psychiatry Physician
  • Costa Mesa, CA
National Provider Identifier
1558577403
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A104521 Issued in CA
Practice address
3150 Bristol St Ste 400
Costa Mesa, CA 92626-3054
Phone
(949) 266-3700
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MDR-4409 HI
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A104521 CA Primary

Addresses

Primary practice location

3150 Bristol St Ste 400
Costa Mesa, CA 92626-3054

Mailing address

3150 Bristol St Ste 400
Costa Mesa, CA 92626-3054
Phone (949) 266-3700

Other practice location 1

1356 Lusitana St Fl 4
Honolulu, HI 96813-2421
Phone (808) 586-2900

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 28, 2014 through Jan 28, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A104521CAMDPsychiatry Physician
MDR-4409HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amen Clinics, Inc PastSince Jul 24, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558577403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 BRISTOL ST STE 400",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263054",
            "telephone_number": "949-266-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 BRISTOL ST STE 400",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263054",
            "telephone_number": "949-266-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1356 Lusitana St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132421",
            "country_code": "US",
            "telephone_number": "808-586-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "JENNIFER",
        "middle_name": "LOVE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MDR-4409",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A104521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.