MEDICARE: MANDANA NAGHI

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
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1609915792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDANA NAGHI

Provider Business Mailing Address
First Line	:	PO BOX 291624
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-9624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-3033
Country	:	US
Telephone Number	:	323-766-2400
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/03/2010

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Directions to “ MANDANA NAGHI ” Practice Location

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