Provider Demographics
NPI:1972118974
Name:BRIGHTER FUTURE PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:BRIGHTER FUTURE PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHDAVI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-917-7773
Mailing Address - Street 1:PO BOX 4403
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91308-4403
Mailing Address - Country:US
Mailing Address - Phone:818-917-7773
Mailing Address - Fax:
Practice Address - Street 1:15456 VENTURA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3023
Practice Address - Country:US
Practice Address - Phone:818-917-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1396057550Medicaid