Healthcare Provider Details

I. General information

NPI: 1770398331
Provider Name (Legal Business Name): BAHAR AMINI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 ALMADEN BLVD STE 600
SAN JOSE CA
95113-1605
US

IV. Provider business mailing address

17595 HARVARD AVE # 10101
IRVINE CA
92614-8516
US

V. Phone/Fax

Practice location:
  • Phone: 949-400-4240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: