Healthcare Provider Details

I. General information

NPI: 1609613082
Provider Name (Legal Business Name): ZANJBEEL MAHMOOD PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD STE 4057
LONG BEACH CA
90807-3320
US

IV. Provider business mailing address

3711 LONG BEACH BLVD STE 4057
LONG BEACH CA
90807-3320
US

V. Phone/Fax

Practice location:
  • Phone: 619-880-6911
  • Fax:
Mailing address:
  • Phone: 562-204-6646
  • Fax: 562-684-6846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34686
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: