Provider Demographics
NPI:1245330067
Name:JAHAN, MOJGAN J (PSYD)
Entity type:Individual
Prefix:MS
First Name:MOJGAN
Middle Name:J
Last Name:JAHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 VILLA LA JOLLA DR
Mailing Address - Street 2:SUITE B214
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1714
Mailing Address - Country:US
Mailing Address - Phone:858-546-1100
Mailing Address - Fax:858-455-0141
Practice Address - Street 1:8950 VILLA LA JOLLA DR
Practice Address - Street 2:SUITE B214
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1714
Practice Address - Country:US
Practice Address - Phone:858-546-1100
Practice Address - Fax:858-455-0141
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19101103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical