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Individual

MRS. BEHNOUSH MORTAZAVI

Active
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Individual

MRS. BEHNOUSH MORTAZAVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C, MSN

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202470
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
20470
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
001263
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20470
NP LICENSE
CA
Enumeration date
03/23/2011
Last updated
10/22/2014
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