Provider Demographics
NPI:1295982858
Name:PARTOVI, HAIDEH KHOSROWSHAHI (MFT)
Entity type:Individual
Prefix:
First Name:HAIDEH
Middle Name:KHOSROWSHAHI
Last Name:PARTOVI
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 1:11400 PELTON PL
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7868
Mailing Address - Country:US
Mailing Address - Phone:916-956-9220
Mailing Address - Fax:916-638-3626
Practice Address - Street 1:7996 OLD WINDING WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7159
Practice Address - Country:US
Practice Address - Phone:916-956-9220
Practice Address - Fax:916-638-3626
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36354101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health