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General NPI Number Information
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NPI Number | 1588849749
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Entity Type | Individual
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Provider Name | ELHAM EHTESHAMI-HUNT MFT
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Gender | Female
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 333 CORPORATE DR STE 260
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City | LADERA RANCH
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State | CA
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Zip | 92694-2180
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Country | US
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Telephone | 949-456-4265
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Fax | 949-269-7957
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Provider Business Mailing Address
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Address Line | 12625 FREDERICK ST STE I5 #317
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City | MORENO VALLEY
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State | CA
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Zip | 92553-5235
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Country | US
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Telephone | 949-456-4265
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Fax | 949-269-7957
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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 | MFC 43068
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License Number State | CA
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