Provider Demographics
NPI:1861688616
Name:ZAHEDIN-LABBAF, GOLNAR
Entity Type:Individual
Prefix:MS
First Name:GOLNAR
Middle Name:
Last Name:ZAHEDIN-LABBAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 LONG BEACH BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2020
Mailing Address - Country:US
Mailing Address - Phone:310-383-3436
Mailing Address - Fax:
Practice Address - Street 1:4201 LONG BEACH BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2020
Practice Address - Country:US
Practice Address - Phone:310-383-3436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT53405106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist