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General NPI Number Information
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NPI Number | 1184181786
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Entity Type | Organization
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Legal Business Name | CONGRUENT LIVES INC
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Dates
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Enumeration Date | 03/01/2019
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 451 W LAMBERT RD STE 212
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City | BREA
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State | CA
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Zip | 92821-3920
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Country | US
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Telephone | 949-293-6249
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Fax |
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Provider Business Mailing Address
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Address Line | 451 W LAMBERT RD STE 212
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City | BREA
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State | CA
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Zip | 92821-3920
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Country | US
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Telephone | 949-293-6249
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YASAMIN FARHAD
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Credential | LMFT, PHD
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Telephone | 949-293-6249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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