Healthcare Provider Details

I. General information

NPI: 1538013552
Provider Name (Legal Business Name): NOVA CLINICAL FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19712 MACARTHUR BLVD STE 110
IRVINE CA
92612-2407
US

IV. Provider business mailing address

PO BOX 80254
RANCHO SANTA MARGARITA CA
92688-0254
US

V. Phone/Fax

Practice location:
  • Phone: 424-420-3551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHAGHAYEGH MAZAHERIAN
Title or Position: PRESIDENT
Credential:
Phone: 424-420-3551