Provider Demographics
NPI:1154344554
Name:MORSHEDIAN, FARSHIDEH FARA
Entity type:Individual
Prefix:DR
First Name:FARSHIDEH
Middle Name:FARA
Last Name:MORSHEDIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281E COLORADO BLVD 1003
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91102-7047
Mailing Address - Country:US
Mailing Address - Phone:310-780-3427
Mailing Address - Fax:
Practice Address - Street 1:919 N SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-1244
Practice Address - Country:US
Practice Address - Phone:800-257-8715
Practice Address - Fax:800-819-1655
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL121120OtherBLUE CROSS BLUE SHIELD
CA680009853OtherRAIL ROAD
CAPSY121120Medicaid
CAWCP12112AMedicare ID - Type Unspecified