Provider Demographics
NPI:1881452761
Name:ALLAMEH, PANIZ
Entity type:Individual
Prefix:
First Name:PANIZ
Middle Name:
Last Name:ALLAMEH
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 1:843 HUCKLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-7908
Mailing Address - Country:US
Mailing Address - Phone:858-731-6984
Mailing Address - Fax:
Practice Address - Street 1:843 HUCKLEBERRY LN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-7908
Practice Address - Country:US
Practice Address - Phone:858-731-6984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health