Provider Demographics
NPI:1477813665
Name:DIAGNOSTIC & COUNSELING CENTER INC
Entity Type:Organization
Organization Name:DIAGNOSTIC & COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BAHAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:TALEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-307-0741
Mailing Address - Street 1:26500 AGOURA RD STE 102-401
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1952
Mailing Address - Country:US
Mailing Address - Phone:818-307-0741
Mailing Address - Fax:818-394-6409
Practice Address - Street 1:30125 AGOURA RD STE 2B
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4345
Practice Address - Country:US
Practice Address - Phone:818-630-5744
Practice Address - Fax:818-394-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21252251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1477813665OtherNPPES