Provider Demographics
NPI:1700547809
Name:HAGHANI, NEDA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:HAGHANI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:NEDA
Other - Middle Name:LALEH
Other - Last Name:HAGHIGHI, NAFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 WATERWORKS WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3169
Mailing Address - Country:US
Mailing Address - Phone:949-753-1522
Mailing Address - Fax:949-753-6075
Practice Address - Street 1:501 S IDAHO ST STE 260
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6594
Practice Address - Country:US
Practice Address - Phone:562-501-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019420363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health