Provider Demographics
NPI:1497203939
Name:CROSS CULTURAL EXPRESSIONS
Entity Type:Organization
Organization Name:CROSS CULTURAL EXPRESSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MASTANEH
Authorized Official - Middle Name:GOLIAN
Authorized Official - Last Name:MOGHADAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-933-1148
Mailing Address - Street 1:17514 VENTURA BLVD
Mailing Address - Street 2:#101
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3852
Mailing Address - Country:US
Mailing Address - Phone:818-860-1223
Mailing Address - Fax:818-960-0274
Practice Address - Street 1:17530 VENTURA BLVD # 203
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3818
Practice Address - Country:US
Practice Address - Phone:818-860-1223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 23095251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health