DR. NATHAN PARK FARREY PSYD
NPI 1104719996
Psychologist - Clinical in Fullerton, CA
- Individual
- Male
- Psychologist
- Clinical
- Opted-Out Medicare
About NATHAN FARREY
This page provides the complete NPI Profile along with additional information for Nathan Farrey, a provider established in Fullerton, California with a medical specialization in Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1104719996 assigned on May 2025. The practitioner's primary taxonomy code is 103TC0700X with license number 34067 (CA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1104719996 Verify this NPI
- Provider Name
- DR. NATHAN PARK FARREY PSYD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 110 E WILSHIRE AVE STE G4 FULLERTON, CA 92832
- Location Phone
- (657) 341-2598
- Mailing Address
- 110 E WILSHIRE AVE STE G4 FULLERTON, CA 92832
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-30-2025
- Last Update Date
- 06-30-2025
- Code Navigator
A clinical psychologist like Nathan Farrey assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Nathan Farrey opted out of Medicare effective on 03-22-2023 until 03-22-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical
- Taxonomy Code
- 103TC0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 34067
- License State
- CA
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 03-22-2023
Opt-Out End Date: 03-22-2027
Eligible to Order and Refer? No
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Other Providers at the Same Location
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104719996, enumerated as an "individual" on May 30, 2025.
The provider is located at 110 E WILSHIRE AVE STE G4 FULLERTON, CA 92832 and the phone number is (657) 341-2598.
Psychologist with taxonomy code 103TC0700X and a focus in Clinical.
