Provider Demographics
NPI:1063000552
Name:HEDAYAT, ZARI (PHD; LMFT)
Entity Type:Individual
Prefix:DR
First Name:ZARI
Middle Name:
Last Name:HEDAYAT
Suffix:
Gender:F
Credentials:PHD; LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11980 SAN VICENTE BLVD STE 909
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6607
Mailing Address - Country:US
Mailing Address - Phone:310-457-8039
Mailing Address - Fax:
Practice Address - Street 1:11980 SAN VICENTE BLVD STE 909
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6607
Practice Address - Country:US
Practice Address - Phone:310-457-8039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22248106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist