Basic Information
| Provider Information | |||||||||
| NPI: | 1487949608 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DILLON | ||||||||
| FirstName: | NARGES | ||||||||
| MiddleName: | ZOHOURY | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ZOHOURY | ||||||||
| OtherFirstName: | NARGES | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 36543 SAN PEDRO DR | ||||||||
| Address2: | APT 184 | ||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945366459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083860612 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 609 PRICE AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503668436 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2011 | ||||||||
| LastUpdateDate: | 11/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 77269 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.