Healthcare Provider Details

I. General information

NPI: 1922572486
Provider Name (Legal Business Name): FARZANEH MOUSAVI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25186 HANCOCK AVE STE 110
MURRIETA CA
92562-5998
US

IV. Provider business mailing address

25186 HANCOCK AVE STE 110
MURRIETA CA
92562-5998
US

V. Phone/Fax

Practice location:
  • Phone: 951-888-3323
  • Fax: 951-888-3561
Mailing address:
  • Phone: 951-888-3323
  • Fax: 951-888-3561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95011299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: