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General NPI Number Information
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NPI Number | 1154759637
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Entity Type | Organization
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Legal Business Name | JAVAPSYCHIATRY
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 13425 VENTURA BLVD STE 102
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3995
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Country | US
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Telephone | 818-430-4241
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Fax | 323-434-4788
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Provider Business Mailing Address
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Address Line | 13425 VENTURA BLVD STE 102
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3995
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Country | US
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Telephone | 818-430-4241
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Fax | 323-434-4788
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. NEDA JAVAHERIAN
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Credential | ND
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Telephone | 818-430-4241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A105749
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License Number State | CA
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