Provider Demographics
NPI:1992380083
Name:HOLAKOUEE, FARHANG (MFT)
Entity Type:Individual
Prefix:
First Name:FARHANG
Middle Name:
Last Name:HOLAKOUEE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11845 W OLYMPIC BLVD # 820
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1149
Mailing Address - Country:US
Mailing Address - Phone:310-273-7636
Mailing Address - Fax:310-441-0019
Practice Address - Street 1:11845 W OLYMPIC BLVD # 820
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1149
Practice Address - Country:US
Practice Address - Phone:310-273-7636
Practice Address - Fax:310-441-0019
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31760101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty