Provider Demographics
NPI:1518481415
Name:GHAJAR, NAHID S (LMFT)
Entity Type:Individual
Prefix:
First Name:NAHID
Middle Name:S
Last Name:GHAJAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:NAHID
Other - Middle Name:S
Other - Last Name:GHAJAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:23432 BOLIVAR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2215
Mailing Address - Country:US
Mailing Address - Phone:949-457-3500
Mailing Address - Fax:
Practice Address - Street 1:4199 CAMPUS DR STE 550
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4694
Practice Address - Country:US
Practice Address - Phone:949-813-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT100372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist