Provider Demographics
NPI:1689877318
Name:GHARACHAMANI, BAHRAM
Entity Type:Individual
Prefix:
First Name:BAHRAM
Middle Name:
Last Name:GHARACHAMANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 OAKDALE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6546
Mailing Address - Country:US
Mailing Address - Phone:833-227-3454
Mailing Address - Fax:
Practice Address - Street 1:16380 ROSCOE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-1221
Practice Address - Country:US
Practice Address - Phone:833-227-3454
Practice Address - Fax:502-589-8771
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health