Individual
ASHKAN RAFAEL SHADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1167 ROXBURY DR, LOS ANGELES, CA 90035-1046
(310) 592-1576
Mailing address
1167 ROXBURY DR, LOS ANGELES, CA 90035-1046
(310) 592-1576
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
LMFT135824
CA
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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