Healthcare Provider Details

I. General information

NPI: 1053511923
Provider Name (Legal Business Name): FARIBA KHATABI PFITZNER M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 S ELLSWORTH RD STE 135
MESA AZ
85212-2168
US

IV. Provider business mailing address

8350 E RAINTREE DR STE 130
SCOTTSDALE AZ
85260-2692
US

V. Phone/Fax

Practice location:
  • Phone: 480-967-6888
  • Fax:
Mailing address:
  • Phone: 602-717-8774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34628
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number34628
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: