Provider Demographics
NPI:1902625247
Name:AFSANEH K ALISOBHANI, PSYD, A MARRIAGE AND FAMILY THERAPY PROFESSIONAL
Entity type:Organization
Organization Name:AFSANEH K ALISOBHANI, PSYD, A MARRIAGE AND FAMILY THERAPY PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AFSANEH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ALISOBHANI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-222-0733
Mailing Address - Street 1:1101 DOVE ST STE 165
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2862
Mailing Address - Country:US
Mailing Address - Phone:949-222-0733
Mailing Address - Fax:
Practice Address - Street 1:1101 DOVE ST STE 165
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2862
Practice Address - Country:US
Practice Address - Phone:949-222-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty