Provider Demographics
NPI:1225430838
Name:ASHOORIYOUN, MATIN (PSYCH ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:MATIN
Middle Name:
Last Name:ASHOORIYOUN
Suffix:
Gender:M
Credentials:PSYCH ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16661 VENTURA BLVD STE 400-F
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1914
Mailing Address - Country:US
Mailing Address - Phone:310-867-1996
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD STE 400-F
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:310-994-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2016-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist