Fazlollah Aldavoud, PHD is a
Psychologist - Clinical based in Norco, California. Fazlollah Aldavoud is licensed to practice in California (license number PSY 16601) and his current practice location is
Fifth And Western California Rehabilitation Center, Dept Of Corrections State Of California, Norco, California. He can be reached at his office (for appointments etc.) via phone at
(951) 737-2683.
NPI number for Fazlollah Aldavoud is 1619170958 and his current mailing address is 1460 Torreyanna Circle, Corona, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619170958.
Healthcare Provider's Profile
Full Name | Fazlollah Aldavoud |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | Fifth And Western California Rehabilitation Center, Norco, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1619170958
- Provider Enumeration Date: 06/06/2007
- Last Update Date: 07/25/2022
Medical Identifiers
Medical identifiers for Fazlollah Aldavoud such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619170958 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
106H00000X | Marriage & Family Therapist | MFC 23813 (California) | Secondary |
174400000X | Specialist | 25147 (California) | Secondary |
103TC0700X | Psychologist - Clinical | PSY 16601 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fazlollah Aldavoud is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Fazlollah Aldavoud, PHD 1460 Torreyanna Circle, Corona, CA 92882-8724 Ph: (951) 582-0895 | Fazlollah Aldavoud, PHD Fifth And Western California Rehabilitation Center, Dept Of Corrections State Of California, Norco, CA 92860 Ph: (951) 737-2683 |
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