Provider Demographics
NPI:1942368311
Name:DR ZARI S CENTER FOR CREATIVE TRANSFORMATION
Entity Type:Organization
Organization Name:DR ZARI S CENTER FOR CREATIVE TRANSFORMATION
Other - Org Name:DR.ZARI'S CENTER FOR CREATIVE TRANSFORMATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZARI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:310-849-4680
Mailing Address - Street 1:13428 MAXELLA AVE # 738
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5620
Mailing Address - Country:US
Mailing Address - Phone:310-849-4680
Mailing Address - Fax:
Practice Address - Street 1:12304 SANTA MONICA BLVD # 315
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2551
Practice Address - Country:US
Practice Address - Phone:310-849-4680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP17628Medicare UPIN
CAWCP17628AMedicare PIN