Provider Demographics
NPI:1508068917
Name:BORDBAR, FARZANEH OVEYSSI (LMFT)
Entity Type:Individual
Prefix:MS
First Name:FARZANEH
Middle Name:OVEYSSI
Last Name:BORDBAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27201 PUERTA REAL STE 300
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8590
Mailing Address - Country:US
Mailing Address - Phone:949-215-7878
Mailing Address - Fax:
Practice Address - Street 1:27201 PUERTA REAL STE 300
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8590
Practice Address - Country:US
Practice Address - Phone:949-215-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist