MEDICARE: LADAN TAHERI-TEHRANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1023592151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LADAN TAHERI-TEHRANI

Provider Business Mailing Address
First Line	:	1146 N CENTRAL AVE STE 621
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2506
Country	:	US
Telephone Number	:	818-925-2410
Fax Number	:	818-925-2411

Provider Business Practice Location Address
First Line	:	1146 N CENTRAL AVE STE 261
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2506
Country	:	US
Telephone Number	:	818-925-2410
Fax Number	:	818-925-2411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	04/20/2023

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Directions to “ LADAN TAHERI-TEHRANI ” Practice Location

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