Provider Demographics
NPI:1437599966
Name:BARKHORDARI, NASRIN (MA)
Entity Type:Individual
Prefix:MRS
First Name:NASRIN
Middle Name:
Last Name:BARKHORDARI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 TAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3027
Mailing Address - Country:US
Mailing Address - Phone:818-609-9989
Mailing Address - Fax:818-757-7106
Practice Address - Street 1:5536 TAMPA AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3027
Practice Address - Country:US
Practice Address - Phone:818-609-9989
Practice Address - Fax:818-757-7106
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist