Provider Demographics
NPI:1205415254
Name:MOHSENI, SOUNA (ASW)
Entity Type:Individual
Prefix:
First Name:SOUNA
Middle Name:
Last Name:MOHSENI
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:SOUNA
Other - Middle Name:
Other - Last Name:MOHSENI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:23315 LA CRESCENTA APT A
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6873
Mailing Address - Country:US
Mailing Address - Phone:747-230-9245
Mailing Address - Fax:
Practice Address - Street 1:27001 LA PAZ RD STE 448-BA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5502
Practice Address - Country:US
Practice Address - Phone:747-230-9245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1004691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical