Provider Demographics
NPI:1508933821
Name:KASHANI, HALEH (PHD)
Entity Type:Individual
Prefix:DR
First Name:HALEH
Middle Name:
Last Name:KASHANI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 LAS GALLINAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3410
Mailing Address - Country:US
Mailing Address - Phone:415-444-3522
Mailing Address - Fax:415-444-3019
Practice Address - Street 1:820 LAS GALLINAS AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3410
Practice Address - Country:US
Practice Address - Phone:415-444-3522
Practice Address - Fax:415-444-3019
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical