MEDICARE: DIAGNOSTIC & COUNSELING CENTER INC

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	251S00000X	Community/Behavioral Health Agency	PSY21252	CA
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1477813665	OTHER	CA	NPPES

General Provider Information

NPI Number	:	1477813665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC & COUNSELING CENTER INC

Provider Business Mailing Address
First Line	:	26500 AGOURA RD STE 102-401
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1952
Country	:	US
Telephone Number	:	818-307-0741
Fax Number	:	818-394-6409

Provider Business Practice Location Address
First Line	:	30125 AGOURA RD STE 2B
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4345
Country	:	US
Telephone Number	:	818-630-5744
Fax Number	:	818-394-6409

Authorized Official
Title or Position	:	OWNER
Name	:	BAHAREH TALEI
Credential	:
Telephone Number	:	818-307-0741

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	10/22/2023

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