Fazlallah Aldavoud PHD

NPI 1619170958 - Psychologist - 103TC0700X

NPI Details
NPI 1619170958
Gender Male
Enumeration Date 06/06/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
FIFTH AND WESTERN CALIFORNIA REHABILITATION CENTER
DEPT OF CORRECTIONS STATE OF CALIFORNIA
NORCO CA, 92860, US
Phone (951) 737-2683
Fax (951) 273-2974
Business Location
1460 TORREYANNA CIRCLE
CORONA CA, 92882-8724, US
Phone (951) 582-0895
Fax
Toxanomy
Taxonomy Code 103TC0700X
License State California
License Number PSY 16601
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According to our database, Fazlallah Aldavoud PHD NPI is 1619170958, taxonomy code is 103TC0700X and license number is PSY 16601, license state is located at California. Fazlallah Aldavoud PHD physically located at Fifth And Western California Rehabilitation Center, Norco CA, 92860. NPI Number Fazlallah Aldavoud PHD has the Individual type.

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1619170958 NPI number is provided on an as is basis without warranty of any kind. 1619170958 is maintained by the National Plan & Provider Enumeration System. The contents of Fazlallah Aldavoud PHD are for informational purposes only.