Individual
MRS. ANITA TAVAKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 WHATNEY UNIT 100, IRVINE, CA 92618-2879
(703) 395-1649
Mailing address
129 CALDERON, IRVINE, CA 92618-1058
(703) 395-1649
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
CA
376G00000X
Nursing Home Administrator
—
CA
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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