Provider Demographics
NPI:1467464677
Name:AMINI, FARIBA (PT)
Entity Type:Individual
Prefix:
First Name:FARIBA
Middle Name:
Last Name:AMINI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 STANFORD CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1666
Mailing Address - Country:US
Mailing Address - Phone:949-387-1699
Mailing Address - Fax:949-387-1699
Practice Address - Street 1:263 STANFORD CT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1666
Practice Address - Country:US
Practice Address - Phone:949-387-1699
Practice Address - Fax:949-387-1699
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist