Provider Demographics
NPI:1376009498
Name:KHACHI, ALINA (MFT)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:KHACHI
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 1:7342 BOTHWELL RD
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2401
Mailing Address - Country:US
Mailing Address - Phone:310-435-9234
Mailing Address - Fax:
Practice Address - Street 1:TARZANA TREATMENT CENTERS
Practice Address - Street 2:18646 OXNARD ST.
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:888-777-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT111087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist