Healthcare Provider Details

I. General information

NPI: 1306094685
Provider Name (Legal Business Name): FERIAL MIRABADI PINCHASI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MOTOR AVE
LOS ANGELES CA
90034-3710
US

IV. Provider business mailing address

12207 CANTURA ST
STUDIO CITY CA
91604-2504
US

V. Phone/Fax

Practice location:
  • Phone: 310-204-1666
  • Fax:
Mailing address:
  • Phone: 818-535-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberRPS2012259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: