Healthcare Provider Details

I. General information

NPI: 1821348533
Provider Name (Legal Business Name): NAZANEIN NAZZI VAZIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19401 S VERMONT AVE STE A200
TORRANCE CA
90502-4418
US

IV. Provider business mailing address

19401 S VERMONT AVE STE A200
TORRANCE CA
90502-4418
US

V. Phone/Fax

Practice location:
  • Phone: 310-323-6887
  • Fax: 310-436-8285
Mailing address:
  • Phone: 310-323-6887
  • Fax: 310-436-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: