MEDICARE: ATEFEH REZAEE

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	101YM0800X	Mental Health Counselor	APCC22615	CA

General Provider Information

NPI Number	:	1184558181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATEFEH REZAEE

Provider Business Mailing Address
First Line	:	5349 NEWCASTLE AVE APT 21
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-3041
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5349 NEWCASTLE AVE APT 21
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-3041
Country	:	US
Telephone Number	:	818-470-0041
Fax Number	:

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

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ ATEFEH REZAEE ” Practice Location

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