MARJAN FARDGHASSEMI PSYD.
NPI 1073921359
Psychologist - Clinical in Los Angeles, CA

Active since July 30, 2014PECOS EnrolledAccepts Medicare Assignment
4929 WILSHIRE BLVD, SUITE NUMBER 510, LOS ANGELES, CA 90010(562) 904-3999(855) 688-6746 Get Directions Write a Review

NPPES record last updated: March 29, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 29, 2018, Jan 20, 2017 (2 updates tracked since 2017).

About Marjan Fardghassemi Psyd. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARJAN FARDGHASSEMI PSYD. (NPI 1073921359) is an individual clinical provider in Los Angeles, California, licensed in California (PSY26145) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1073921359
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMARJAN FARDGHASSEMICredential: PSYD.
Location Address4929 WILSHIRE BLVD, SUITE NUMBER 510Los Angeles, CA 90010-3808
Mailing Address4929 Wilshire Blvd, Suite Number 510Los Angeles, CA 90010-3808 · (562) 904-3999 · Fax (855) 688-6746
Fax(855) 688-6746
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 30, 2014
Last NPPES UpdateMarch 29, 20182 updates tracked since enumeration
NPI 1073921359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in CA · PSY26145
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologistTaxonomy 103T00000X · License PSY26145 (CA)
4929 WILSHIRE BLVD, Los Angeles, CA 90010

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Marjan Fardghassemi Psyd. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749407310
PECOS Enrollment IDI20140806001004
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
4929 WILSHIRE BLVD, #930
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, STE 510
LOS ANGELES, CA 90010
Psychologist
4929 WILSHIRE BLVD, SUITE 510
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, SUITE 510
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, SUITE NUMBER 510
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, SUITE 510
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, SUITE NUMBER 510
LOS ANGELES, CA 90010
Psychologist (Clinical)
4929 WILSHIRE BLVD, SUITE NUMBER 510
LOS ANGELES, CA 90010

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073921359, enumerated as an "individual" on July 30, 2014.

The provider is located at 4929 WILSHIRE BLVD SUITE NUMBER 510 LOS ANGELES, CA 90010 and the phone number is (562) 904-3999.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.