Healthcare Provider Details

I. General information

NPI: 1417086208
Provider Name (Legal Business Name): LIMOR DAGAN MA, MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23480 PARK SORRENTO
CALABASAS CA
91302-1306
US

IV. Provider business mailing address

PO BOX 573034
TARZANA CA
91357-3034
US

V. Phone/Fax

Practice location:
  • Phone: 818-575-6149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number47889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: