MEDICARE: SOPHIE NIKFARJAM M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	141650	CA

General Provider Information

NPI Number	:	1053185207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIE NIKFARJAM M.A.

Provider Business Mailing Address
First Line	:	5884 WASHINGTON BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-7339
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5884 WASHINGTON BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-7339
Country	:	US
Telephone Number	:	323-834-9692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2023
Last Update Date	:	09/22/2025

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