Provider Demographics
NPI:1891683322
Name:NIKBAKHT, ALI (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:NIKBAKHT
Suffix:
Gender:M
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32041 CAMPANULA WAY APT 15205
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-8683
Mailing Address - Country:US
Mailing Address - Phone:951-365-1157
Mailing Address - Fax:
Practice Address - Street 1:2810 CAMINO DEL RIO S STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3819
Practice Address - Country:US
Practice Address - Phone:619-967-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129524106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist