1588827083 NPI number — MARCEE DORAI ZARI MS MFT INTERN

Table of content: MARCEE DORAI ZARI MS MFT INTERN (NPI 1588827083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588827083 NPI number — MARCEE DORAI ZARI MS MFT INTERN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZARI
Provider First Name:
MARCEE
Provider Middle Name:
DORAI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS MFT INTERN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AGLIO
Provider Other First Name:
MARCEE
Provider Other Middle Name:
DORAI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588827083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
650 TAMARACK AVE
Provider Second Line Business Mailing Address:
# 1102
Provider Business Mailing Address City Name:
BREA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92821-3202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-631-0036
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
223 WEST BASELINE RD
Provider Second Line Business Practice Location Address:
400
Provider Business Practice Location Address City Name:
LA VERNE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91750-0400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-593-2581
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7565A . This is a "OUTPATIENT MENTAL HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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