Provider Demographics
NPI:1538982772
Name:SOLEIMANI, NIMA
Entity type:Individual
Prefix:
First Name:NIMA
Middle Name:
Last Name:SOLEIMANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NIMA
Other - Middle Name:
Other - Last Name:SOLEYMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1356
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1356
Practice Address - Country:US
Practice Address - Phone:661-214-3063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-24-390739106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician