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General NPI Number Information
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NPI Number | 1225279821
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Entity Type | Individual
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Provider Name | IMAN MORIDI
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Gender | Male
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 11344 COLOMA RD STE 660
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City | GOLD RIVER
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State | CA
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Zip | 95670-4464
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Country | US
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Telephone | 916-251-9379
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Fax |
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Provider Business Mailing Address
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Address Line | 6181 ALBERT ALY
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-6944
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Country | US
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Telephone | 916-892-6092
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 129318
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License Number State | CA
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