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General NPI Number Information
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NPI Number | 1144561630
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Entity Type | Individual
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Provider Name | FARIDEH GHOLIZADEH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 813 VAN NUYS BLVD SUITE 200
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4818
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Country | US
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Telephone | 818-591-8430
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Fax |
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Provider Business Mailing Address
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Address Line | 24517 VIA ESQUINA
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City | CALABASAS
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State | CA
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Zip | 91302-3068
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Country | US
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Telephone | 818-591-8430
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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