NPIMap

Organization Active NPI

Allied Psychological Services, P.C.

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1619487287
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ALLIED PSYCHOLOGICAL SERVICES, P.C.
Practice address
23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908
Phone
(949) 329-7337
NPI assigned
Oct 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Samira Vafadar, PSYDNPI 1689963514
Title
Owner/ Clinical Psychologist
Phone
(714) 394-0017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908

Mailing address

21 Crockett
Irvine, CA 92620-3331
Phone (714) 394-0017

Other practice location 1

23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908
Phone (949) 329-3733

Other identifiers 1

IdentifierTypeStateIssuer
PSY28213OtherCABOARD OF PSYCHOLOGY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180117002208 CA Part B Supplier - Clinic/Group Practice 1759640816 Receives reassigned benefits from 9 practitioners
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

4740 Von Karman Ave
Ste 120
Newport Beach, CA 92660
Phone (949) 910-3197

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1619487287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CROCKETT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203331",
            "telephone_number": "714-394-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CORPORATE PLAZA DR STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607908",
            "telephone_number": "949-329-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Corporate Plaza Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926607908",
            "country_code": "US",
            "telephone_number": "949-329-3733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLIED PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "VAFADAR",
        "authorized_official_first_name": "SAMIRA",
        "authorized_official_title_or_position": "OWNER/ CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "714-394-0017",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSY28213",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.