Provider Demographics
NPI:1336509645
Name:ESFAHANI, NAFISEH (PSYD)
Entity Type:Individual
Prefix:
First Name:NAFISEH
Middle Name:
Last Name:ESFAHANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20331 FLANAGAN RD
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-2550
Mailing Address - Country:US
Mailing Address - Phone:714-552-2353
Mailing Address - Fax:
Practice Address - Street 1:20331 FLANAGAN RD
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-9263
Practice Address - Country:US
Practice Address - Phone:714-552-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor