MEDICARE: PSYCH EVAL, 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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1659203909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCH EVAL, 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	:

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	:	818-307-0741
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	BAHAREH TALEI
Credential	:	PSY.D.
Telephone Number	:	818-307-0741

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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