Individual provider Active NPI

Nelly Nassar

  • Clinical Psychologist
  • Camarillo, CA
National Provider Identifier
1932358264
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23313 Issued in CA
Practice address
771 E Daily Dr Ste 310
Camarillo, CA 93010-0784
Phone
(805) 507-5549
NPI assigned
Sep 10, 2008
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X PSY23313 CA Primary

Addresses

Primary practice location

771 E Daily Dr Ste 310
Camarillo, CA 93010-0784

Mailing address

771 E Daily Dr Ste 310
Camarillo, CA 93010-0784
Phone (805) 507-5549

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
I20150908000797 CA Practitioner - Clinical Psychologist 6608182605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Growing Minds Psychological CorporationGroup PAC ID 3870817414, 9 clinicians

Practice addresses (Care Compare)

16800 Devonshire St
Suite 301
Granada Hills, CA 91344-7410
Phone (323) 459-4968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY23313CAMDClinical Psychologist
23313CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A.M.P. Autism Inc Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1932358264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 E DAILY DR STE 310",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930100784",
            "telephone_number": "805-507-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 E DAILY DR STE 310",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930100784",
            "telephone_number": "805-507-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSAR",
        "first_name": "NELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.