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NPI Code Detail

MEDICARE: GOLENA AKHTEH

MEDICARE: GOLENA AKHTEH
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist79999CA

General Provider Information

NPI Number : 1063505618
Entity Type Code : Individual
Provider Name (Legal Business Name) : GOLENA AKHTEH
Provider Business Mailing Address
First Line : 1328 2ND ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1122
Country : US
Telephone Number : 310-576-1308
Fax Number : 310-576-1027
Provider Business Practice Location Address
First Line : 3435 OCEAN PARK BLVD #207
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3314
Country : US
Telephone Number : 310-392-9474
Fax Number : 310-392-7341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/01/2014

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Directions to “ GOLENA AKHTEH ” Practice Location

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