MEDICARE: INTEGRATIVE PSYCHOLOGY ASSOCIATES, INC.

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

General Provider Information

NPI Number	:	1164199139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE PSYCHOLOGY ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	21243 VENTURA BLVD STE 243
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2168
Country	:	US
Telephone Number	:	661-309-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	21243 VENTURA BLVD STE 243
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2168
Country	:	US
Telephone Number	:	661-309-3338
Fax Number	:

Authorized Official
Title or Position	:	LMFT
Name	:	MS. NEDA POURSHAHIDI
Credential	:
Telephone Number	:	661-309-3338

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/26/2021

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