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General NPI Number Information
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NPI Number | 1659135564
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Entity Type | Individual
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Provider Name | SANDRA SHAHROKH LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 15300 VENTURA BLVD STE 408
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-5848
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Country | US
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Telephone | 818-732-0948
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Fax |
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Provider Business Mailing Address
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Address Line | 15231 MAGNOLIA BLVD UNIT 218
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1140
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 144838
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License Number State | CA
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