Provider Demographics
NPI:1952531584
Name:ALISOBHANI, AFSANEH KIANY (PSYD)
Entity Type:Individual
Prefix:
First Name:AFSANEH
Middle Name:KIANY
Last Name:ALISOBHANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19742 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2432
Mailing Address - Country:US
Mailing Address - Phone:949-222-0733
Mailing Address - Fax:
Practice Address - Street 1:19742 MACARTHUR BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2432
Practice Address - Country:US
Practice Address - Phone:949-222-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102L00000X
CAMFC29614106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst