Provider Demographics
NPI:1710208293
Name:YOUSEFIAN TEHRANI, FLOR
Entity Type:Individual
Prefix:
First Name:FLOR
Middle Name:
Last Name:YOUSEFIAN TEHRANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLORIN
Other - Middle Name:
Other - Last Name:YOUSEFIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2777 ALTON PKWY
Mailing Address - Street 2:APT 368
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3143
Mailing Address - Country:US
Mailing Address - Phone:949-387-6277
Mailing Address - Fax:
Practice Address - Street 1:1001 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4121
Practice Address - Country:US
Practice Address - Phone:714-687-6740
Practice Address - Fax:714-667-7717
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 60600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist