Provider Demographics
NPI:1841156650
Name:DEHGHANPOUR, LALEH
Entity type:Individual
Prefix:
First Name:LALEH
Middle Name:
Last Name:DEHGHANPOUR
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 1:1616 W CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-2128
Mailing Address - Country:US
Mailing Address - Phone:951-706-0028
Mailing Address - Fax:714-494-8028
Practice Address - Street 1:1616 W CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-2128
Practice Address - Country:US
Practice Address - Phone:951-706-0028
Practice Address - Fax:714-494-8028
Is Sole Proprietor?:No
Enumeration Date:2025-12-25
Last Update Date:2025-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician