| Fereshte Mirzad, Psychologist P.c. | |
|
18811 Huntington St Ste 200 Huntington Beach CA 92648-6003 | |
| (818) 274-8056 | |
| Not Available |
| Full Name | Fereshte Mirzad, Psychologist P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 18811 Huntington St Ste 200, Huntington Beach, California |
| Authorized Official Name and Position | Fereshte Mirzad (PSYCHOLOGIST) |
| Authorized Official Contact | 8182748056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fereshte Mirzad, Psychologist P.c. 18811 Huntington St Ste 200 Huntington Beach CA 92648-6003 Ph: (818) 274-8056 | Fereshte Mirzad, Psychologist P.c. 18811 Huntington St Ste 200 Huntington Beach CA 92648-6003 Ph: (818) 274-8056 |
| NPI Number | 1730867177 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 07/06/2023 |
| Certification Date | 05/31/2023 |
| Medicare PECOS PAC ID | 7719349125 |
|---|---|
| Medicare Enrollment ID | O20230817000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730867177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Fereshte Mirzad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689041188 PECOS PAC ID: 8628430030 Enrollment ID: I20230817000978 |
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