Provider Demographics
NPI:1235615543
Name:LEILI ZARBAKHSH INTEGRATED INDIVIDUAL AND FAMILY THERAPY PROF. CORP.
Entity Type:Organization
Organization Name:LEILI ZARBAKHSH INTEGRATED INDIVIDUAL AND FAMILY THERAPY PROF. CORP.
Other - Org Name:WILLOWBROOKS BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEILI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARBAKHSH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LEP
Authorized Official - Phone:747-447-2090
Mailing Address - Street 1:4642 NOELINE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2104
Mailing Address - Country:US
Mailing Address - Phone:310-383-5259
Mailing Address - Fax:
Practice Address - Street 1:5005 CANYON CREST DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7721
Practice Address - Country:US
Practice Address - Phone:747-447-2090
Practice Address - Fax:747-444-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty