Provider Demographics
NPI:1720627466
Name:JAZAIERI, HOORIA (LMFT)
Entity type:Individual
Prefix:DR
First Name:HOORIA
Middle Name:
Last Name:JAZAIERI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 HAMILTON AVE # 1666
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2543
Mailing Address - Country:US
Mailing Address - Phone:408-462-1447
Mailing Address - Fax:
Practice Address - Street 1:380 HAMILTON AVE # 1666
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2543
Practice Address - Country:US
Practice Address - Phone:408-462-1447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC-53748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health