Healthcare Provider Details

I. General information

NPI: 1861227720
Provider Name (Legal Business Name): NIOUSHA ALAMDAR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 EAST COLORADO BLVD ST 200
PASADENA CA
91105
US

IV. Provider business mailing address

5906 MCDONIE AVE
WOODLAND HILLS CA
91367-5532
US

V. Phone/Fax

Practice location:
  • Phone: 844-669-7827
  • Fax:
Mailing address:
  • Phone: 310-980-5855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number417096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: