Provider Demographics
NPI:1144349085
Name:MAJIDZADEH, MANOCHER (MS-LMFT)
Entity type:Individual
Prefix:
First Name:MANOCHER
Middle Name:
Last Name:MAJIDZADEH
Suffix:
Gender:M
Credentials:MS-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5943
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93755-5943
Mailing Address - Country:US
Mailing Address - Phone:559-549-6610
Mailing Address - Fax:
Practice Address - Street 1:3313 N SONORA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-4668
Practice Address - Country:US
Practice Address - Phone:559-549-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46118106H00000X
CA43497106H00000X
CA4618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist