Individual provider Active NPI

Haya Alsarhn Bahbah, PSYD

  • Clinical Psychologist
  • Glendora, CA
National Provider Identifier
1609497130
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31764 Issued in CA
Practice address
1620 S Grand Ave
Glendora, CA 91740-5433
Phone
(626) 335-1919
Fax
(626) 335-1911
NPI assigned
May 6, 2020
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31764 CA Primary

Addresses

Primary practice location

1620 S Grand Ave
Glendora, CA 91740-5433

Mailing address

1620 S Grand Ave
Glendora, CA 91740-5433
Phone (626) 335-1919

Other identifiers 1

IdentifierTypeStateIssuer
PSY31764OtherCAPSYD

Other names 1

  • Haya Alsarhn Former name

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
I20230428001505 CA Practitioner - Clinical Psychologist 3678938503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1620 S Grand Ave
Glendora, CA 91740-5433
Phone (626) 335-1919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31764CAMDMental Health Counselor
PSY31764CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. CurrentSince Mar 15, 2023 Accepting new patients
Inland Psychiatric Medical Group, Inc. Clinical CurrentSince Mar 15, 2023 Accepting new patients

Locations

1620 S Grand Ave
Glendora, CA 91740
Phone (626) 335-1919

1656 W Avenue J
Lancaster, CA 93534
Phone (661) 942-1169

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

Organizations & group practices 2

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1609497130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405433",
            "telephone_number": "626-335-1919",
            "fax_number": "626-335-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405433",
            "telephone_number": "626-335-1919",
            "fax_number": "626-335-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHBAH",
        "first_name": "HAYA",
        "middle_name": "ALSARHN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYD",
            "identifier": "PSY31764",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYA",
            "last_name": "ALSARHN",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.