Provider Demographics
NPI:1558488031
Name:YASHAR, NILOUFAR (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:NILOUFAR
Middle Name:
Last Name:YASHAR
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:DR
Other - First Name:NILOUFAR
Other - Middle Name:
Other - Last Name:YASHAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LMFT
Mailing Address - Street 1:701 S NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1831
Mailing Address - Country:US
Mailing Address - Phone:213-385-5100
Mailing Address - Fax:
Practice Address - Street 1:2121 W TEMPLE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4915
Practice Address - Country:US
Practice Address - Phone:213-385-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT37773101YM0800X
CA37773106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist