MEDICARE: BRIGHTER FUTURE PSYCHOLOGICAL SERVICES 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	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972118974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER FUTURE PSYCHOLOGICAL SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 4403
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91308-4403
Country	:	US
Telephone Number	:	818-917-7773
Fax Number	:

Provider Business Practice Location Address
First Line	:	15456 VENTURA BLVD STE 500
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-3023
Country	:	US
Telephone Number	:	818-917-7773
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. AMIR MAHDAVI
Credential	:	PH.D.
Telephone Number	:	818-917-7773

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	09/15/2020

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