Provider Demographics
NPI:1528378320
Name:NOVID, AMIRNAZ (LMFT)
Entity Type:Individual
Prefix:
First Name:AMIRNAZ
Middle Name:
Last Name:NOVID
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 1:4000 BARRANCA PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1713
Mailing Address - Country:US
Mailing Address - Phone:949-533-3335
Mailing Address - Fax:
Practice Address - Street 1:4000 BARRANCA PKWY
Practice Address - Street 2:STE 250
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4710
Practice Address - Country:US
Practice Address - Phone:949-533-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist