Shamlou, Kiyanoosh
Shamlou, Kiyanoosh is an sole proprietor health care provider with primary practice located at 4199 Campus Dr Suite 550, Irvine CA 92612-4684. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Shamlou, Kiyanoosh can be contacted via phone (714) 585-5380.Contact Information
Primary practice address
4199 Campus Dr Suite 550
Irvine CA 92612-4684
Phone: (714) 585-5380
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counseling | 103TC1900X | PSY26074 | California |
Behavioral Health & Social Service Providers / Family | 103TF0000X | PSY26074 | California |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY26074 | California |
Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | PSY 26074 | California |
Profile Details
NPI number | 1083036537 |
---|---|
LBN Legal business name | Shamlou, Kiyanoosh |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 16th, 2014 |
Last updated | Mar 25th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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