Healthcare Provider Details

I. General information

NPI: 1659203909
Provider Name (Legal Business Name): PSYCH EVAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30125 AGOURA RD STE 2B
AGOURA HILLS CA
91301-4345
US

IV. Provider business mailing address

26500 AGOURA RD STE 102-401
CALABASAS CA
91302-1952
US

V. Phone/Fax

Practice location:
  • Phone: 818-307-0741
  • Fax:
Mailing address:
  • Phone: 818-307-0741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: BAHAREH TALEI
Title or Position: FOUNDER
Credential: PSY.D.
Phone: 818-307-0741