Individual provider Active NPI

Fariba Mazdeh, NP

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1669786117
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11615 Issued in OH
Practice address
333 1St St Ste a
San Francisco, CA 94105-2661
Phone
(888) 803-3370
Fax
(888) 803-3331
NPI assigned
Jul 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G186782 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 269497 AZ
Family Nurse Practitioner 363LF0000X 0024183198 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024183198 VA
Family Nurse Practitioner 363LF0000X 11615 OH Primary
Nurse Practitioner 363L00000X 12.014988 CT
Family Nurse Practitioner 363LF0000X 95019754 CA
Family Nurse Practitioner 363LF0000X G186782 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95019754 CA
Family Nurse Practitioner 363LF0000X 269497 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11615 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14988 CT

Addresses

Primary practice location

333 1St St Ste a
San Francisco, CA 94105-2661

Mailing address

5109 Delancey St
Columbus, OH 43220-2570
Phone (614) 584-3834

Other practice location 1

540 Litchfield St
Torrington, CT 06790-6679
Phone (972) 449-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA, AZ, CT, VA, IA, FL, ID, WA, NC, PA, TX, DC13 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
I20101026000537 OH Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 4 organizations
I20230417001952 CA Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 3 organizations
I20250625002479 AZ Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20250709001269 CT Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20250709001461 VA Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20250924004433 IA Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251001000891 FL Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251001004374 ID Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251015001968 WA Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251017003368 NC Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251029001706 PA Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20251204001966 TX Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization
I20260615001527 DC Practitioner - Nurse Practitioner 3072706704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1717 Main St
Suite 5850
Dallas, TX 75201-4681

1717 Main St
Suite 5850
Dallas, TX 75201-7317

331 1St St
Suite a
San Francisco, CA 94105-2661

5109 Delanley St
Columbus, OH 43017

5109 Delanley St
Columbus, OH 43220

5109 Delanley St
Columbus, OH 43220-2570

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12.014988CTMDNurse Practitioner
95019754CAMDFamily Nurse Practitioner
0024183198VAMDFamily Nurse Practitioner
269497AZMDPsychiatric/Mental Health Nurse Practitioner
11615OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC Nurse Practitioner CurrentSince Jun 12, 2025 Accepting new patients
Lifesource of North Carolina Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
Lifesource of North Carolina Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
Incare Health Solutions LLC CurrentSince Sep 7, 2019 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Apr 13, 2023 Accepting new patients
Forefront Telecare Inc CurrentSince Dec 10, 2025 Accepting new patients
Access Telecare California, P.C. Nurse Practitioner CurrentSince Jun 12, 2025 Accepting new patients
Ohiohealth Employer Services, LLC Family CurrentSince Aug 1, 2018 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Sep 7, 2019 Accepting new patients
Circle Medical Care of California CurrentSince Mar 16, 2026 Accepting new patients
Shine Medical of Ca PC Past Accepting new patients
Access Behavioral LLC PastSince Aug 9, 2020 Accepting new patients
Phoenix Group Home, LLC Past Accepting new patients
Main Street Family Medicine ,LLC PastSince Dec 11, 2006 Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations (25 of 27)

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

415 N Crescent Dr
Ste 320
Beverly Hills, CA 90210
Phone (415) 510-2755

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

450 E Romie Ln
Salinas, CA 93901
Phone (831) 372-7844

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

20 York St
North Haven, CT 06510
Phone (203) 688-2433

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

115 N Calhoun St
Ste 4
Tallahassee, FL 32301
Phone (323) 776-3632

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

410 W Elm St
Bluffton, OH 45817
Phone (419) 358-1015

5555 Cleveland Ave
Columbus, OH 43231
Phone (614) 788-5280

Dept L3652
Columbus, OH 43260

1525 Eber Rd
Holland, OH 43528
Phone (419) 866-6500

175 Edgefield Blvd
Marion, OH 43302
Phone (740) 751-6433

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

8400 E Broad St
Reynoldsburg, OH 43068
Phone (614) 328-8090

20171 Chasewood Park Dr
Houston, TX 77070
Phone (713) 355-1000

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/
  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1669786117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 DELANCEY ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202570",
            "telephone_number": "614-584-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 1ST ST STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941052661",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 LITCHFIELD ST",
            "address_purpose": "LOCATION",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906679",
            "country_code": "US",
            "telephone_number": "972-449-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZDEH",
        "first_name": "FARIBA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G186782",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "269497",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183198",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024183198",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "11615",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "12.014988",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019754",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "G186782",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019754",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "269497",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "11615",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "14988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.