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NPI 1104249176

NPI 1104249176 : MANDANA SAIDI : LA CRESCENTA, CA

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General NPI Number Information
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    NPI Number           |    1104249176
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    Entity Type          |    Individual 
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    Provider Name        |    MANDANA SAIDI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/28/2014
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    Last Update Date     |    01/28/2014
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Provider Practice Location Address
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    Address Line         |    3001 GERTRUDE AVE 
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    City                 |    LA CRESCENTA
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    State                |    CA
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    Zip                  |    91214-1910
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    Country              |    US
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    Telephone            |    818-350-2614
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9354 TUJUNGA CANYON BLVD. 
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    City                 |    TUJUNGA
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    State                |    CA
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    Zip                  |    91042
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    Country              |    US
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    Telephone            |    818-415-3445
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    80181
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    License Number State |    CA
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