Provider Demographics
NPI:1407576457
Name:CHAMANI, AZIZEH (MS)
Entity Type:Individual
Prefix:
First Name:AZIZEH
Middle Name:
Last Name:CHAMANI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61580
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-6052
Mailing Address - Country:US
Mailing Address - Phone:949-468-6120
Mailing Address - Fax:
Practice Address - Street 1:3950 LONG BEACH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-5410
Practice Address - Country:US
Practice Address - Phone:562-684-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10072101YM0800X
CA127353106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health