Provider Demographics
NPI:1609554476
Name:VISHEH, PARYA
Entity Type:Individual
Prefix:MRS
First Name:PARYA
Middle Name:
Last Name:VISHEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26730 TOWNE CENTRE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2857
Mailing Address - Country:US
Mailing Address - Phone:949-559-5153
Mailing Address - Fax:949-559-5252
Practice Address - Street 1:26730 TOWNE CENTRE DR STE 102
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2857
Practice Address - Country:US
Practice Address - Phone:949-559-5153
Practice Address - Fax:949-559-5252
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF07230424363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care