Provider Demographics
NPI:1548789589
Name:DR. PARIE PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:DR. PARIE PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:DR. PARIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARIDNIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-424-3472
Mailing Address - Street 1:2081 BUSINESS CENTER DR STE 109
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1185
Mailing Address - Country:US
Mailing Address - Phone:949-424-3472
Mailing Address - Fax:
Practice Address - Street 1:2081 BUSINESS CENTER DR STE 109
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1185
Practice Address - Country:US
Practice Address - Phone:949-424-3472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26838261QM0801X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health