Provider Demographics
NPI:1306866991
Name:AMINI, MINOO TARAZ (MS, LMFT, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MINOO
Middle Name:TARAZ
Last Name:AMINI
Suffix:
Gender:F
Credentials:MS, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 A EAST PALMDALE BLVD.
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550
Mailing Address - Country:US
Mailing Address - Phone:661-223-3819
Mailing Address - Fax:661-537-2937
Practice Address - Street 1:2323 A EAST PALMDALE BLVD.
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550
Practice Address - Country:US
Practice Address - Phone:661-223-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000794101YP2500X
CAIMF 56087106H00000X
CALMFT80894106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF 56087OtherBBS
CT000794OtherLPC