MEDICARE: DR. ASAL HOUSHIARNEJAD PSYD

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	225C00000X	Rehabilitation Counselor
2	103G00000X	Clinical Neuropsychologist	28994	CA

General Provider Information

NPI Number	:	1861860223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASAL HOUSHIARNEJAD PSYD

Provider Business Mailing Address
First Line	:	23632 CALABASAS RD STE 201
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1737
Country	:	US
Telephone Number	:	424-209-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	23632 CALABASAS RD STE 201
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1737
Country	:	US
Telephone Number	:	424-209-4345
Fax Number	:

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

Provider Enumeration Date	:	09/02/2015
Last Update Date	:	06/22/2023

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