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General NPI Number Information
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NPI Number | 1114391935
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Entity Type | Individual
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Provider Name | SOHEILA HOSSEINI PHD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 127 BROADWAY STE 200
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City | SANTA MONICA
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State | CA
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Zip | 90401-2330
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Country | US
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Telephone | 310-857-4946
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Fax | 310-601-5193
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Provider Business Mailing Address
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Address Line | 127 BROADWAY STE 200
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City | SANTA MONICA
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State | CA
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Zip | 90401-2330
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Country | US
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Telephone | 310-857-4946
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Fax | 310-601-5193
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY29987
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY29987
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY29987
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License Number State | CA
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