Provider Demographics
NPI:1093910804
Name:NOORBAKHSH, SOHEILA (MFT)
Entity Type:Individual
Prefix:MS
First Name:SOHEILA
Middle Name:
Last Name:NOORBAKHSH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 N LINDEN DR STE 448
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4903
Mailing Address - Country:US
Mailing Address - Phone:310-281-8870
Mailing Address - Fax:310-275-4270
Practice Address - Street 1:462 N LINDEN DR STE 448
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4903
Practice Address - Country:US
Practice Address - Phone:310-281-8870
Practice Address - Fax:310-275-4270
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist