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NPI Code Detail

MEDICARE: DR. PAYAM JAFARI ED.D.

MEDICARE: DR. PAYAM JAFARI ED.D.
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
1103T00000XPsychologistPSY29184CA

General Provider Information

NPI Number : 1417207358
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAYAM JAFARI ED.D.
Provider Business Mailing Address
First Line : 113 WATERWORKS WAY STE 100
Second Line :
City : IRVINE
State : CA
Zip : 92618-3171
Country : US
Telephone Number : 949-231-9968
Fax Number :
Provider Business Practice Location Address
First Line : 23 CORPORATE PLAZA DR STE 150
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-7908
Country : US
Telephone Number : 949-329-3733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 07/21/2022

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