Provider Demographics
NPI:1821158403
Name:TABRIZY, SYDELLE (MS, MFT)
Entity Type:Individual
Prefix:MRS
First Name:SYDELLE
Middle Name:
Last Name:TABRIZY
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17852 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2801
Mailing Address - Country:US
Mailing Address - Phone:714-216-4735
Mailing Address - Fax:
Practice Address - Street 1:19742 MC ARTHUR AVE.
Practice Address - Street 2:STE. #125
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614
Practice Address - Country:US
Practice Address - Phone:714-216-4493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30711170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS