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Individual

EDGAR SHAHNAZARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LEP

Contact information

Practice address
260 NEWPORT CENTER DR STE 505, NEWPORT BEACH, CA 92660-7520
(424) 375-6193
Mailing address
260 NEWPORT CENTER DR STE 505, NEWPORT BEACH, CA 92660-7520
(424) 375-6193

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4232
CA

Other

Enumeration date
12/20/2024
Last updated
12/20/2024
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