Doctor Name: | PAYAM JAFARI |
NPI Number: | 1417207358 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ED.D. |
License Number: | PSB-37706 |
Business Practice Address: | 1913 E 17th St Ste 119 North Tustin, CA - 927058627 |
Business Phone Number: | 8889585485 |
Business Fax Number: | 7145436730 |
Mailing Address: | 1913 E 17th St Ste 119, NORTH TUSTIN |
State: | CA |
Postal Code: | 927058627 |
Phone Number: | 8889585485 |
Fax Number: | 7145436730 |
NPI Enumeration Date: | 09/19/2012 |
NPI Last Update Date: | 10/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PSB-37706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |