Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY15233 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY15233 | CA |
NPI | 1013005842 |
---|---|
Provider Name | Dr. Azin Asli |
First Address | Orange, CA 92868-2941 |
Second Address | Orange, CA 92868-2941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 02/02/2021 |