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General NPI Number Information
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NPI Number | 1265191928
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Entity Type | Individual
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Provider Name | LEILA MALEKPOUR
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 17837 SHERMAN WAY APT 109
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City | RESEDA
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State | CA
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Zip | 91335-3379
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Country | US
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Telephone | 949-282-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 18646 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1411
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Country | US
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Telephone | 949-282-7464
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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 | 108873
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CA
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