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General NPI Number Information
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NPI Number | 1356077754
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Entity Type | Organization
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Legal Business Name | BLISS PSYCHOTHERAPY BY DR. VAKILI INC.
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 106 JAYBIRD
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City | IRVINE
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State | CA
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Zip | 92618-3518
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Country | US
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Telephone | 916-945-2739
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Fax |
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Provider Business Mailing Address
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Address Line | 106 JAYBIRD
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City | IRVINE
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State | CA
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Zip | 92618-3518
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Country | US
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Telephone | 916-945-2739
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VESAL VAKILI
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Credential | LMFT, PSYD.
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Telephone | 949-300-6608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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