Individual
ALYSA R AZIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5001 BIRCH ST, NEWPORT BEACH, CA 92660-2116
(714) 768-4455
(714) 832-2737
Mailing address
174 PINEVIEW, IRVINE, CA 92620-1926
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC41530
CA
Other
Enumeration date
02/03/2007
Last updated
07/08/2007
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