Healthcare Provider Details

I. General information

NPI: 1891602215
Provider Name (Legal Business Name): DENA GOHARI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 OCEAN PARK BLVD STE 250
SANTA MONICA CA
90405-3239
US

IV. Provider business mailing address

3205 OCEAN PARK BLVD STE 250
SANTA MONICA CA
90405-3239
US

V. Phone/Fax

Practice location:
  • Phone: 310-488-5850
  • Fax: 310-295-2446
Mailing address:
  • Phone: 310-488-5850
  • Fax: 310-295-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSB94029540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: