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General NPI Number Information
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NPI Number | 1578829271
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Entity Type | Individual
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Provider Name | DANESH FOROUGHI PH.D., MFCC
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Gender | Male
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 15720 VENTURA BLVD 209
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City | ENCINO
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State | CA
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Zip | 91436-2914
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Country | US
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Telephone | 310-940-3642
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Fax |
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Provider Business Mailing Address
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Address Line | 12115 SAN VICENTE BLVD 308
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City | LOS ANGELES
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State | CA
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Zip | 90049-4942
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Country | US
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Telephone | 310-940-3642
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY13680
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFCC23455
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License Number State | CA
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