Provider Demographics
NPI:1285224816
Name:ATESOGLU, ZEYNEP IRMAK
Entity Type:Individual
Prefix:
First Name:ZEYNEP
Middle Name:IRMAK
Last Name:ATESOGLU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9713 SANTA MONICA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4236
Mailing Address - Country:US
Mailing Address - Phone:310-564-5400
Mailing Address - Fax:844-654-2900
Practice Address - Street 1:9713 SANTA MONICA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4236
Practice Address - Country:US
Practice Address - Phone:310-564-5400
Practice Address - Fax:844-654-2900
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142211106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXXXMedicaid