Shafiezadeh, Behrooz
Shafiezadeh, Behrooz is an individual health care provider with primary practice located at 2101 Courage Dr , Fairfield CA 94533-6717. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Shafiezadeh, Behrooz can be contacted via phone (707) 784-2077.Contact Information
Primary practice address
2101 Courage Dr
Fairfield CA 94533-6717
Phone: (707) 784-2077
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 139343 | California |
Profile Details
| NPI number | 1639613409 |
|---|---|
| LBN Legal business name | Shafiezadeh, Behrooz |
| Credentials | LMFT, APCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2016 |
| Last updated | Jun 1st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639613409 | NPPES |
| California | Other | C5252989 | DRIVER LICENCE |
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