Provider Demographics
NPI:1073169397
Name:SHIRIN PEYKAR, LICENSED MARRIAGE AND FAMILY THERAPIST & ASSOCIATES INC
Entity Type:Organization
Organization Name:SHIRIN PEYKAR, LICENSED MARRIAGE AND FAMILY THERAPIST & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYKAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-213-4953
Mailing Address - Street 1:4835 VAN NUYS BLVD STE 1-200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2109
Mailing Address - Country:US
Mailing Address - Phone:310-213-4953
Mailing Address - Fax:
Practice Address - Street 1:4835 VAN NUYS BLVD STE 1-200
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2109
Practice Address - Country:US
Practice Address - Phone:310-213-4953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty