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NPI Code Detail

MEDICARE: BABAK GOVAN PHD LLC

MEDICARE: BABAK GOVAN PHD LLC
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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1568870608
Entity Type Code : Organization
Provider Name (Legal Business Name) : BABAK GOVAN PHD LLC
Provider Business Mailing Address
First Line : 18946 TUBA ST
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91324-1230
Country : US
Telephone Number : 818-522-2106
Fax Number : 503-388-4144
Provider Business Practice Location Address
First Line : 10260 SW GREENBURG ROAD
Second Line : SUITE 400
City : PORTLAND
State : OR
Zip : 97223-5500
Country : US
Telephone Number : 503-575-1317
Fax Number : 503-388-4144
Authorized Official
Title or Position : OWNER/PSYCHOLOGIST
Name : DR. BABAK GOVAN
Credential : PHD
Telephone Number : 503-575-1317
Provider Enumeration Date : 07/31/2014
Last Update Date : 04/06/2026

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