Healthcare Provider Details

I. General information

NPI: 1992184535
Provider Name (Legal Business Name): NILOUFAR B. TOHIDIAN M.S., PSY.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 GODDARD
IRVINE CA
92618-4610
US

IV. Provider business mailing address

410 GODDARD
IRVINE CA
92618-4610
US

V. Phone/Fax

Practice location:
  • Phone: 949-244-1773
  • Fax:
Mailing address:
  • Phone: 949-244-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC334
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number86056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: