Individual provider Active NPI

Naysan Malakouti-Nejad

  • Clinical Psychologist
  • Calabasas, CA
National Provider Identifier
1558804450
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33391 Issued in CA
Practice address
23901 Calabasas Rd Ste 1076
Calabasas, CA 91302-1581
Phone
(424) 354-9287
NPI assigned
Nov 23, 2016
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY33391 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

23901 Calabasas Rd Ste 1076
Calabasas, CA 91302-1581

Mailing address

23901 Calabasas Rd Ste 1076
Calabasas, CA 91302-1581
Phone (424) 354-9287

Other practice location 1

954 W Foothill Blvd Ste A
Upland, CA 91786-3782
Phone (909) 946-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117002170 CA Practitioner - Clinical Psychologist 0941678270 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY33391CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Mission City Community Network, Inc. CurrentSince Feb 21, 2024 Accepting new patients
Mission City Community Network, Inc. CurrentSince Feb 21, 2024 Accepting new patients

Locations

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone (818) 882-0009

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

15206 Parthenia St
Sepulveda, CA 91343

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

15201 Eleventh St
Ste 300
Victorville, CA 92395
Phone (760) 245-1640

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1558804450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23901 CALABASAS RD STE 1076",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021581",
            "telephone_number": "424-354-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23901 CALABASAS RD STE 1076",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021581",
            "telephone_number": "424-354-9287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "954 W Foothill Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917863782",
            "country_code": "US",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAKOUTI-NEJAD",
        "first_name": "NAYSAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-23",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33391",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.