MEDICARE: DR. HALEH EGHRARI PH.D.

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	103TC0700X	Clinical Psychologist	PSY13673	CA

General Provider Information

NPI Number	:	1417993429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HALEH EGHRARI PH.D.

Provider Business Mailing Address
First Line	:	10700 SANTA MONICA BLVD STE 300
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6587
Country	:	US
Telephone Number	:	310-441-9550
Fax Number	:	310-234-2682

Provider Business Practice Location Address
First Line	:	10700 SANTA MONICA BLVD STE 300
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6587
Country	:	US
Telephone Number	:	310-441-9550
Fax Number	:	310-234-2682

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	02/07/2025

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