| Harbor Psychiatry & Mental Health, Professional Corporation | |
|
4631 Teller Ave Ste 100 Newport Beach CA 92660-8105 | |
| (949) 887-7187 | |
| (949) 476-3080 |
| Full Name | Harbor Psychiatry & Mental Health, Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4631 Teller Ave Ste 100, Newport Beach, California |
| Authorized Official Name and Position | Gisoo Zarrabi (PRESIDENT/MEDICAL DIRECTOR) |
| Authorized Official Contact | 9493387158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor Psychiatry & Mental Health, Professional Corporation 4631 Teller Ave Ste 100 Newport Beach CA 92660-8105 Ph: (949) 887-7187 | Harbor Psychiatry & Mental Health, Professional Corporation 4631 Teller Ave Ste 100 Newport Beach CA 92660-8105 Ph: (949) 887-7187 |
| NPI Number | 1780050054 |
|---|---|
| Provider Enumeration Date | 08/20/2015 |
| Last Update Date | 03/23/2022 |
| Certification Date | 03/23/2022 |
| Medicare PECOS PAC ID | 8729394572 |
|---|---|
| Medicare Enrollment ID | O20150825004062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780050054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A117990 (California) | Primary |
| Provider Name | Arde Anoshivani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396845186 PECOS PAC ID: 2466349691 Enrollment ID: I20040302001365 |
| Provider Name | Balaji Nettimi |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1285882175 PECOS PAC ID: 9133251630 Enrollment ID: I20100720000064 |
| Provider Name | Sherri A Tanferani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124272695 PECOS PAC ID: 4486840501 Enrollment ID: I20101201000052 |
| Provider Name | Gail Fnp Bernstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609159854 PECOS PAC ID: 3971777566 Enrollment ID: I20111116000647 |
| Provider Name | Kristin Jean Wilkerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326387556 PECOS PAC ID: 7719100403 Enrollment ID: I20140528000159 |
| Provider Name | Grace E Kwon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326347873 PECOS PAC ID: 3971811159 Enrollment ID: I20160908000250 |
| Provider Name | Hadi Estakhri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003161522 PECOS PAC ID: 5294030367 Enrollment ID: I20170818002114 |
| Provider Name | Atih A Seif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821332099 PECOS PAC ID: 4082969001 Enrollment ID: I20180615000835 |
| Provider Name | Todd Andrews |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467647982 PECOS PAC ID: 4981950847 Enrollment ID: I20180706001240 |
| Provider Name | Harrell M Reznick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295085660 PECOS PAC ID: 3971853201 Enrollment ID: I20180907001900 |
| Provider Name | Tracy A Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285834424 PECOS PAC ID: 5890033823 Enrollment ID: I20190215002224 |
| Provider Name | Darrell Vincecruz Deguzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245709112 PECOS PAC ID: 8426390477 Enrollment ID: I20190424000202 |
| Provider Name | Anthony J Mele |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619021599 PECOS PAC ID: 7113029182 Enrollment ID: I20190701000457 |
| Provider Name | Carrie Ann Kimpton Heald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982039426 PECOS PAC ID: 6305071127 Enrollment ID: I20190731001623 |
| Provider Name | Susan V Swartz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265550362 PECOS PAC ID: 7517294671 Enrollment ID: I20190812003476 |
| Provider Name | Catherine Ann Francis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952560245 PECOS PAC ID: 0648602292 Enrollment ID: I20191119003345 |
| Provider Name | Ralph Gunther Kuechle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780771253 PECOS PAC ID: 7315373214 Enrollment ID: I20200213001195 |
| Provider Name | Erin Fraser Benesch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144529926 PECOS PAC ID: 9234565037 Enrollment ID: I20200213001672 |
| Provider Name | Kelly Krueger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861767386 PECOS PAC ID: 3375979149 Enrollment ID: I20200214001749 |
| Provider Name | Dina Zayat |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902917180 PECOS PAC ID: 6709917180 Enrollment ID: I20200416000679 |
| Provider Name | Helen Kienzle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629386180 PECOS PAC ID: 3274963780 Enrollment ID: I20200424001275 |
| Provider Name | Emily Louise Lippincott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972134641 PECOS PAC ID: 0749602373 Enrollment ID: I20200626001584 |
| Provider Name | Vanessa Staples |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992299028 PECOS PAC ID: 6709138670 Enrollment ID: I20210113002394 |
| Provider Name | Scott Lester Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164551933 PECOS PAC ID: 8224206701 Enrollment ID: I20210219001437 |
| Provider Name | Mary L Berst |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619295938 PECOS PAC ID: 6305245622 Enrollment ID: I20210518003071 |
| Provider Name | Ghulam Mustafa Surti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861499675 PECOS PAC ID: 1456331354 Enrollment ID: I20210714003735 |
| Provider Name | John Earl Xiong-chapman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467797431 PECOS PAC ID: 8426450131 Enrollment ID: I20210716001054 |
| Provider Name | Hugh D Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386146439 PECOS PAC ID: 3476972928 Enrollment ID: I20211022002166 |
| Provider Name | Olivia Taylor Defilippo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033704572 PECOS PAC ID: 6800284134 Enrollment ID: I20220121000691 |
| Provider Name | Kiefer Greenspan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629573464 PECOS PAC ID: 9830521327 Enrollment ID: I20220802002742 |
| Provider Name | Galya Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023724176 PECOS PAC ID: 6709241094 Enrollment ID: I20230419002401 |
| Provider Name | Gauri Saxena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225659618 PECOS PAC ID: 0547625923 Enrollment ID: I20230509000784 |
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