Organization
DR AZADEH GOLSHANI PSYCHOLOGIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZADEH GOLSHANI PSY.D (PSYCHOLOGIST)
(310) 927-9853
Entity
Organization
Contact information
Practice address
3415 S SEPULVEDA BLVD STE 1100, LOS ANGELES, CA 90034-7090
(310) 927-9853
Mailing address
11045 MISSOURI AVE APT 203, LOS ANGELES, CA 90025-5625
(310) 927-9853
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY28464
CA
261QM0850X
Adult Mental Health Clinic/Center
PSY28464
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
PSY28464
—
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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