Individual provider Active NPI

Faezeh Nassry, M.D.

  • Psychiatry Physician
  • Pasadena, CA
National Provider Identifier
1922462274
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A172293 Issued in CA
Practice address
675 S Arroyo Pkwy Ste 430
Pasadena, CA 91105-3972
Phone
(424) 284-2440
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Psychiatry Physician 2084P0800X A172293 CA Primary

Addresses

Primary practice location

675 S Arroyo Pkwy Ste 430
Pasadena, CA 91105-3972

Mailing address

675 S Arroyo Pkwy Ste 420
Pasadena, CA 91105-3215

Other practice location 1

4518 Verdugo Rd
Los Angeles, CA 90065-4932
Phone (818) 858-6525

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241018000650 CA Practitioner - Psychiatry 3274065909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

675 S Arroyo Pkwy
Suite 420
Pasadena, CA 91105-3215
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A172293CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Psychiatry CurrentSince Sep 14, 2024 Accepting new patients

Locations

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

675 S Arroyo Pkwy
Ste 420
Pasadena, CA 91105
Phone (626) 795-0617

100 Howe Ave
Ste 170N
Sacramento, CA 95825
Phone (415) 296-5100

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.faezehnassry@148377.advancedmd-direct.com

Organizations & group practices 1

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1922462274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 420",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 430",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053972",
            "telephone_number": "424-284-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4518 Verdugo Rd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900654932",
            "country_code": "US",
            "telephone_number": "818-858-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASSRY",
        "first_name": "FAEZEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A172293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.