Individual provider Active NPI

Fariba Sharifi, PSY.D

  • Clinical Psychologist
  • Encino, CA
National Provider Identifier
1861742637
Registry record updated Apr 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 25212 Issued in CA
Practice address
5535 Balboa Blvd
Ste 200
Encino, CA 91316-1534
Phone
(818) 620-6646
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2017

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 PSY 25212 CA Primary

Addresses

Primary practice location

5535 Balboa Blvd
Ste 200
Encino, CA 91316-1534

Mailing address

PO Box 571063
Tarzana, CA 91357-1063
Phone (818) 620-6646

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
I20121017000853 CA Practitioner - Clinical Psychologist 6507016078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17337 Ventura Blvd
Suite 222
Encino, CA 91316-3995
Phone (818) 620-6646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 25212CAMDClinical Psychologist
25212CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology Consultants, Inc CurrentSince Feb 1, 2014 Accepting new patients
Fariba Sharifi Psychological Corp. Clinical CurrentSince Apr 7, 2014 Accepting new patients

Locations

17337 Ventura Blvd
Ste 222
Encino, CA 91316
Phone (818) 620-6646

5535 Balboa Blvd
Ste 200
Encino, CA 91316
Phone (818) 620-6646

6399 Wilshire Blvd
Ste 1016
Los Angeles, CA 90048
Phone (818) 274-6749

8635 W 3rd St
Ste 1065W
Los Angeles, CA 90048
Phone (310) 360-0331

640 S Sunset Ave
Ste 102
West Covina, CA 91790
Phone (626) 338-9000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491609600000",
    "number": "1861742637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 571063",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913571063",
            "telephone_number": "818-620-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 BALBOA BLVD",
            "address_2": "STE 200",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161534",
            "telephone_number": "818-620-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFI",
        "first_name": "FARIBA",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2017-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 25212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.