Provider Demographics
NPI:1285963249
Name:SHAHINPOURI, FARAMARZ (LCSW)
Entity type:Individual
Prefix:
First Name:FARAMARZ
Middle Name:
Last Name:SHAHINPOURI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA SIERRA COUNSELING
Mailing Address - Street 2:10800 HOLE AVE., SUIT 4
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2578
Mailing Address - Country:US
Mailing Address - Phone:951-588-8838
Mailing Address - Fax:951-351-2722
Practice Address - Street 1:10800 HOLE AVE STE 4
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-2759
Practice Address - Country:US
Practice Address - Phone:951-588-8838
Practice Address - Fax:951-351-2722
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR658-M104100000X
CA788521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR658-MOtherLMSW