Healthcare Provider Details

I. General information

NPI: 1619255049
Provider Name (Legal Business Name): PRIYA PARIKH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15615 ALTON PKWY STE 230
IRVINE CA
92618-7306
US

IV. Provider business mailing address

84 GRANITE PATH
IRVINE CA
92620-3555
US

V. Phone/Fax

Practice location:
  • Phone: 949-528-6300
  • Fax: 855-779-3627
Mailing address:
  • Phone: 949-297-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY29128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: