Healthcare Provider Details

I. General information

NPI: 1336569862
Provider Name (Legal Business Name): NARGES FEIZABADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE STE 240
IRVINE CA
92618-3724
US

IV. Provider business mailing address

16100 SAND CANYON AVE STE 240
IRVINE CA
92618-3724
US

V. Phone/Fax

Practice location:
  • Phone: 949-393-7443
  • Fax: 949-387-2653
Mailing address:
  • Phone: 949-393-7443
  • Fax: 949-387-2653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95000593
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95000593
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95000593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: