Healthcare Provider Details
I. General information
NPI: 1962642363
Provider Name (Legal Business Name): WINDOWS FOR HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18345 VENTURA BLVD STE 314
TARZANA CA
91356-4242
US
IV. Provider business mailing address
18345 VENTURA BLVD STE 314
TARZANA CA
91356-4242
US
V. Phone/Fax
- Phone: 818-344-6818
- Fax: 818-344-6778
- Phone: 818-344-6818
- Fax: 818-344-6778
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY21541 |
| License Number State | CA |
VIII. Authorized Official
Name:
SHIRIN
NOORAVI
Title or Position: OWNER
Credential: PSYD
Phone: 818-344-6818