Individual
DR. FARIBA KEZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4199 CAMPUS DR, SUITE 550, IRVINE, CA 92612-4696
(714) 490-4965
(949) 509-6599
Mailing address
4199 CAMPUS DR, SUITE 550, IRVINE, CA 92612-4696
(714) 490-4965
(949) 509-6599
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY20295
CA
103T00000X
Psychologist
PSY20295
CA
103TC0700X
Clinical Psychologist
PSY20295
CA
Other
Enumeration date
02/17/2007
Last updated
12/02/2010
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