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NPI Code Detail

MEDICARE: AZEEN NAFISI M.A.

MEDICARE: AZEEN NAFISI M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225C00000XRehabilitation Counselor
2103TC0700XClinical Psychologist34508CA

General Provider Information

NPI Number : 1235625211
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZEEN NAFISI M.A.
Provider Business Mailing Address
First Line : 12626 RIVERSIDE DR STE 409
Second Line :
City : VALLEY VILLAGE
State : CA
Zip : 91607-3451
Country : US
Telephone Number : 818-661-6306
Fax Number :
Provider Business Practice Location Address
First Line : 12626 RIVERSIDE DR STE 409
Second Line :
City : VALLEY VILLAGE
State : CA
Zip : 91607-3451
Country : US
Telephone Number : 818-661-6306
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2018
Last Update Date : 04/05/2024

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Directions to “ AZEEN NAFISI M.A.” Practice Location

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