Provider Demographics
NPI:1851731855
Name:LOTFIZADEH, AMIN DUFF (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:AMIN
Middle Name:DUFF
Last Name:LOTFIZADEH
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24332 ACASO
Mailing Address - Street 2:#5
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:310-699-2248
Mailing Address - Fax:
Practice Address - Street 1:24332 ACASO
Practice Address - Street 2:#5
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92656-3133
Practice Address - Country:US
Practice Address - Phone:310-699-2248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7878103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst