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FAZLOLLAH ALDAVOUD PHD NPI 1619170958


NPI Information

NPI: 1619170958
Provider Name: FAZLOLLAH ALDAVOUD, PHD
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
FIFTH AND WESTERN CALIFORNIA REHABILITATION CENTER
DEPT OF CORRECTIONS STATE OF CALIFORNIA
NORCO, CA
ZIP 92860
Phone: (951) 737-2683
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Fazlollah Aldavoud, PHD is a clinical psychologist in Norco, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Fazlollah Aldavoud, PHD NPI is 1619170958. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

FIFTH AND WESTERN CALIFORNIA REHABILITATION CENTER
DEPT OF CORRECTIONS STATE OF CALIFORNIA
NORCO, CA
ZIP 92860
Phone: (951) 737-2683
Fax: (951) 273-2974

The enumeration date for this NPI number is 6/6/2007 and was last updated on 7/25/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106H00000XMarriage & Family TherapistMFC 23813CALIFORNIANo
2174400000XSpecialist25147CALIFORNIANo
3103TC0700XPsychologistClinicalPSY 16601CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.