Provider Demographics
NPI:1053423822
Name:JILANCHI, SALMIRA (MA, MBA, LMFT)
Entity type:Individual
Prefix:MS
First Name:SALMIRA
Middle Name:
Last Name:JILANCHI
Suffix:
Gender:F
Credentials:MA, MBA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3943 IRVINE BLVD # 226
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2400
Mailing Address - Country:US
Mailing Address - Phone:949-385-3654
Mailing Address - Fax:
Practice Address - Street 1:3943 IRVINE BLVD # 226
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-2400
Practice Address - Country:US
Practice Address - Phone:949-385-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist