Healthcare Provider Details

I. General information

NPI: 1114046299
Provider Name (Legal Business Name): LALEH JILL RAZANI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

18111 NORDHOFF ST
NORTHRIDGE CA
91330-8255
US

V. Phone/Fax

Practice location:
  • Phone: 818-677-4623
  • Fax:
Mailing address:
  • Phone: 818-677-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY17061
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberPSY17061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: