Healthcare Provider Details

I. General information

NPI: 1861860223
Provider Name (Legal Business Name): ASAL HOUSHIARNEJAD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASAL HOUSHIARNEJAD PSYD

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23632 CALABASAS RD STE 201
CALABASAS CA
91302-1737
US

IV. Provider business mailing address

23632 CALABASAS RD STE 201
CALABASAS CA
91302-1737
US

V. Phone/Fax

Practice location:
  • Phone: 424-209-4345
  • Fax:
Mailing address:
  • Phone: 424-209-4345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number28994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: