Provider Demographics
NPI:1780865196
Name:SATTARI, MELINA (MFT)
Entity Type:Individual
Prefix:
First Name:MELINA
Middle Name:
Last Name:SATTARI
Suffix:
Gender:F
Credentials:MFT
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 19
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-0019
Mailing Address - Country:US
Mailing Address - Phone:818-448-2735
Mailing Address - Fax:
Practice Address - Street 1:18345 VENTURA BLVD
Practice Address - Street 2:320
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4232
Practice Address - Country:US
Practice Address - Phone:818-448-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA82474OtherMARRIAGE AND FAMILY THERAPIST