Healthcare Provider Details

I. General information

NPI: 1700792637
Provider Name (Legal Business Name): DELARAM HAJHASSAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 E 17TH ST STE 118
SANTA ANA CA
92705-8627
US

IV. Provider business mailing address

PO BOX 6032
ANAHEIM CA
92816-0032
US

V. Phone/Fax

Practice location:
  • Phone: 801-710-6773
  • Fax:
Mailing address:
  • Phone: 801-710-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: