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General NPI Number Information
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NPI Number | 1063591972
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Entity Type | Individual
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Provider Name | KAVOOS GHANE BASSIRI LMFT, LPCC
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 615 JOHN MUIR DR D617
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-6157
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Country | US
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Telephone | 415-997-9087
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Fax | 415-737-0609
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Provider Business Mailing Address
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Address Line | 615 JOHN MUIR DR D617
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-6157
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Country | US
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Telephone | 415-997-9087
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Fax | 415-737-0609
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 852
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1901525
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F.1900098
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 32987
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License Number State | CA
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