Healthcare Provider Details

I. General information

NPI: 1235252206
Provider Name (Legal Business Name): FOROUGH A. EFTEKHARI LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NONE EFTEKHARI LMFT

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N LAKE AVE FL 8
PASADENA CA
91101-1849
US

IV. Provider business mailing address

PO BOX 228
PASADENA CA
91102-0228
US

V. Phone/Fax

Practice location:
  • Phone: 626-667-0935
  • Fax:
Mailing address:
  • Phone: 626-667-0935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: