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General NPI Number Information
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NPI Number | 1013607985
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Entity Type | Organization
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Legal Business Name | JOY OF CONSCIOUS LIVING
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 13731 OLIVE STREET
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 949-610-6263
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Fax |
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Provider Business Mailing Address
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Address Line | 4521 CAMPUS DR # 231
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City | IRVINE
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State | CA
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Zip | 92612-2621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MINOO DARGAH
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Credential | PSY.D.
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Telephone | 949-610-6263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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