Provider Demographics
NPI:1629143755
Name:ZAHEDI, AVISHAN (MFT)
Entity Type:Individual
Prefix:MISS
First Name:AVISHAN
Middle Name:
Last Name:ZAHEDI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3216
Mailing Address - Country:US
Mailing Address - Phone:619-235-2600
Mailing Address - Fax:619-696-9573
Practice Address - Street 1:1568 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3216
Practice Address - Country:US
Practice Address - Phone:619-235-2600
Practice Address - Fax:619-696-9573
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2012-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health