MEDICARE: LAAL MEHRI GOLBADI

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	132895	CA

General Provider Information

NPI Number	:	1417833658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAAL MEHRI GOLBADI

Provider Business Mailing Address
First Line	:	2060 E AVENIDA DE LOS ARBOLES # 337
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-1361
Country	:	US
Telephone Number	:	818-734-9776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 E AVENIDA DE LOS ARBOLES # 337
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-1361
Country	:	US
Telephone Number	:	818-724-9776
Fax Number	:

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

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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Directions to “ LAAL MEHRI GOLBADI ” Practice Location

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