Provider Demographics
NPI:1730400029
Name:MOAYEDI, NIMA (PSYD)
Entity type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:MOAYEDI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23282 MILL CREEK DR STE 260
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1683
Mailing Address - Country:US
Mailing Address - Phone:949-436-6122
Mailing Address - Fax:949-305-7641
Practice Address - Street 1:23282 MILL CREEK DR STE 260
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1683
Practice Address - Country:US
Practice Address - Phone:949-412-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0200X
CA27997103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic