Provider Demographics
NPI:1649833252
Name:FASSIH, NARGESS
Entity type:Individual
Prefix:MS
First Name:NARGESS
Middle Name:
Last Name:FASSIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9070 IRVINE CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4692
Mailing Address - Country:US
Mailing Address - Phone:714-698-9443
Mailing Address - Fax:
Practice Address - Street 1:9070 IRVINE CENTER DR STE 250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4692
Practice Address - Country:US
Practice Address - Phone:714-698-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112683106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist