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General NPI Number Information
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NPI Number | 1528436193
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Entity Type | Individual
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Provider Name | FARRAH KHALEGHI AIZENMAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2015
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 16861 VENTURA BLVD STE 303
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City | ENCINO
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State | CA
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Zip | 91436-1765
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Country | US
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Telephone | 310-906-4937
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24595
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City | LOS ANGELES
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State | CA
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Zip | 90024-0595
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 30483
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License Number State | CA
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