Provider Demographics
NPI:1497111561
Name:KHAN, RASHIDA (AMFT)
Entity Type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1434
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-5434
Mailing Address - Country:US
Mailing Address - Phone:424-521-2655
Mailing Address - Fax:
Practice Address - Street 1:20695 S WESTERN AVE STE 132
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1834
Practice Address - Country:US
Practice Address - Phone:424-521-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT124760106H00000X
CA124760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist