Healthcare Provider Details
I. General information
NPI: 1972420321
Provider Name (Legal Business Name): MIND MAP PSYCHOLOGICAL & ASSESSMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
238 FOUNTAINHEAD
IRVINE CA
92618-0803
US
IV. Provider business mailing address
238 FOUNTAINHEAD
IRVINE CA
92618-0803
US
V. Phone/Fax
- Phone: 949-385-2621
- Fax:
- Phone: 949-385-2621
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAYEH
GHAZIZADEH
Title or Position: PRESIDENT
Credential: LICENSED CLINICAL PS
Phone: 949-385-2621