Active NPI
Fred Farzanegan, PH. D.
- Clinical Psychologist
- Tampa, FL
National Provider Identifier
1740324706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY3572
- Practice address
- 82 Columbia Dr
Tampa, FL 33606-3538 - Phone
- (813) 785-5577
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY3572 | FL | Primary |
Addresses
Primary practice location
82 Columbia Dr
Tampa, FL 33606-3538
Mailing address
82 Columbia Dr
Tampa, FL 33606-3538
Phone (813) 785-5577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY3572 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1740324706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 COLUMBIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063538",
"telephone_number": "813-785-5577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 COLUMBIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063538",
"telephone_number": "813-785-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARZANEGAN",
"first_name": "FRED",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY3572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.