Provider Demographics
NPI:1043996267
Name:ASAL HOUSHIARNEJAD PSYCHOLOGY GROUP-PC
Entity Type:Organization
Organization Name:ASAL HOUSHIARNEJAD PSYCHOLOGY GROUP-PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSHIARNEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:424-209-4345
Mailing Address - Street 1:23632 CALABASAS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1737
Mailing Address - Country:US
Mailing Address - Phone:424-409-4345
Mailing Address - Fax:
Practice Address - Street 1:23632 CALABASAS RD STE 201
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1737
Practice Address - Country:US
Practice Address - Phone:424-409-4345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health