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General NPI Number Information
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NPI Number | 1629867247
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Entity Type | Individual
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Provider Name | MOJIANA ALAILI MOGHADAM LPCC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 28881 VIA LEONA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-5536
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Country | US
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Telephone | 949-312-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 825 COLLEGE BLVD # 102-143
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City | OCEANSIDE
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State | CA
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Zip | 92057-6263
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Country | US
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Telephone | 949-312-1797
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 16131
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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 | 16131
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License Number State | CA
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