Provider Demographics
NPI:1225262322
Name:BOROUMAND, NAHID (LMFT MFT)
Entity Type:Individual
Prefix:MRS
First Name:NAHID
Middle Name:
Last Name:BOROUMAND
Suffix:
Gender:F
Credentials:LMFT MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DAVEY GLEN ROAD
Mailing Address - Street 2:APT. 4905
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002
Mailing Address - Country:US
Mailing Address - Phone:650-261-6720
Mailing Address - Fax:
Practice Address - Street 1:840 HINCKLEY ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010
Practice Address - Country:US
Practice Address - Phone:650-261-6720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#MFC31517106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist