Farrah Ann Khabagnote, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20150 Issued in CA

Practice address

1369 Sycamore Ave
Hercules, CA 94547-5489

Phone

(707) 410-0540

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1972777498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 SYCAMORE AVE",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945475489",
            "telephone_number": "707-410-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 SYCAMORE AVE",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945475489",
            "telephone_number": "707-410-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHABAGNOTE",
        "first_name": "FARRAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee D Johnson, CNMT, R.T.(N)(ARRT)
• Joscelyn Carol Jones, ESQ.
• Gatimu Kariithi
• Alma Kaufmann
• Victor C.P. Kerenyi, D.C.
• Yeun Joo Kim, D.D.S.
• Shanise Madelena King
• Cole Benjamin Knowlden
• Richard James Wei Hsin Ko, PHARMD
• Kevin Koo, MA, BCBA

• Clinical Psychologist in Hercules, CA
• Providers in Hercules, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.