Provider Demographics
NPI:1992449490
Name:EMAMIAN, SOFIA (LCSW)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:EMAMIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RUE CANNES
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5901
Mailing Address - Country:US
Mailing Address - Phone:949-375-4193
Mailing Address - Fax:
Practice Address - Street 1:121 S LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3423
Practice Address - Country:US
Practice Address - Phone:310-627-5850
Practice Address - Fax:310-627-5855
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical