Healthcare Provider Details

I. General information

NPI: 1811688013
Provider Name (Legal Business Name): EFAF GHAYEM LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 36TH ST
NEWPORT BEACH CA
92663-3204
US

IV. Provider business mailing address

509 36TH ST
NEWPORT BEACH CA
92663-3204
US

V. Phone/Fax

Practice location:
  • Phone: 805-790-2008
  • Fax:
Mailing address:
  • Phone: 949-379-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: