Individual
FERESHTE MIRZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44750 60TH ST W, LANCASTER, CA 93536-7619
(661) 729-2000
Mailing address
PO BOX 800444, SANTA CLARITA, CA 91380-0444
(661) 729-2000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY31397
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2015
Last updated
03/20/2020
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