=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184182545
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PARSHAW BARATI-MARNANI MA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2019
-----------------------------------------------------
Last Update Date | 03/05/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 MARIN ST STE 202
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-4266
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-445-0574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24930 PASEO DEL RANCHO
-----------------------------------------------------
City | CALABASAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91302-3086
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-445-0574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LMFT100032
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------