Provider Demographics
NPI:1982141487
Name:IRANI, PERZAN K
Entity Type:Individual
Prefix:
First Name:PERZAN
Middle Name:K
Last Name:IRANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ASILOMAR RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:949-276-5340
Practice Address - Street 1:28 ASILOMAR RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1022
Practice Address - Country:US
Practice Address - Phone:949-472-4352
Practice Address - Fax:949-276-5340
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor