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General NPI Number Information
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NPI Number | 1952588576
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Entity Type | Individual
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Provider Name | SAHAR SARA TEIMOORI LCSW, PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 2192 MARTIN SUITE 165
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City | IRVINE
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State | CA
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Zip | 92612-1483
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Country | US
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Telephone | 949-752-6268
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Fax | 949-725-0914
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Provider Business Mailing Address
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Address Line | PO BOX 53633
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City | IRVINE
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State | CA
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Zip | 92619-3633
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Country | US
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Telephone | 949-752-6268
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Fax | 949-725-0914
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS17444
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License Number State | CA
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