Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY11769 | CA |
NPI | 1326136599 |
---|---|
Provider Name | Dr. Ellie Karimi |
First Address | Tustin, CA 92780-3256 |
Second Address | Tustin, CA 92780-3256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 14/12/2016 |