Healthcare Provider Details

I. General information

NPI: 1760760623
Provider Name (Legal Business Name): MAHSA HOJAT-KHOSHNIYAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 BAUCHET ST
LOS ANGELES CA
90012-2906
US

IV. Provider business mailing address

1255 FEDERAL AVE APT 103
LOS ANGELES CA
90025-3969
US

V. Phone/Fax

Practice location:
  • Phone: 310-701-3713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: