Fary Jalili

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

118956 Issued in CA

Practice address

4635 Thomas Lake Harris Dr Unit 318
Santa Rosa, CA 95403-0195

Phone

(917) 574-1933

NPI assigned

Jul 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Farzaneh Jalili Other name

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1679926091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 THOMAS LAKE HARRIS DR UNIT 318",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030195",
            "telephone_number": "917-574-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 THOMAS LAKE HARRIS DR UNIT 318",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030195",
            "telephone_number": "917-574-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALILI",
        "first_name": "FARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "118956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARZANEH",
            "last_name": "JALILI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jafa Pharmaceuticals, Inc.
• Mahsa Sadat Jafari
• Robert Torin Jaffe, M.D.
• Ida Jahed, MD
• Lucelene Jaimes Perez
• Naseer Ibraheem Jameel
• Chloe Nissi Mole Jamero
• James a. Abbott, D.D.S., M.S.
• James E O'Dorisio MD a Professional Corporation
• James M. Foley PA

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.