Individual
BANAFSHEH BITA KHAMOOSHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1682 LANGLEY AVE STE 1, IRVINE, CA 92614-5620
(858) 774-0963
Mailing address
1682 LANGLEY AVE STE 1, IRVINE, CA 92614-5620
(858) 774-0963
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
AMFT1305337
CA
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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