Healthcare Provider Details

I. General information

NPI: 1346189420
Provider Name (Legal Business Name): PSYCHOLOGY BEHAVIORAL HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9777 WILSHIRE BLVD STE 907
BEVERLY HILLS CA
90212-1902
US

IV. Provider business mailing address

9777 WILSHIRE BLVD STE 907
BEVERLY HILLS CA
90212-1902
US

V. Phone/Fax

Practice location:
  • Phone: 310-461-8809
  • Fax:
Mailing address:
  • Phone: 310-461-8809
  • 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: PAYAM KHARAZI
Title or Position: PRESIDENT
Credential: PSYD
Phone: 310-461-8809