Provider Demographics
NPI:1225552441
Name:GHAZNAVI, CASSANDRA GABRIELLE
Entity type:Individual
Prefix:MISS
First Name:CASSANDRA
Middle Name:GABRIELLE
Last Name:GHAZNAVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:GABRIELLE
Other - Last Name:DEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16124 ROSECRANS AVE APT 12H
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4237
Mailing Address - Country:US
Mailing Address - Phone:714-702-9216
Mailing Address - Fax:
Practice Address - Street 1:1011 N BEGONIA AVE STE 1009
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2104
Practice Address - Country:US
Practice Address - Phone:800-683-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-29
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health