Provider Demographics
NPI:1255636072
Name:EMRANI, NAKISA RABBANY (LMFT)
Entity type:Individual
Prefix:MS
First Name:NAKISA
Middle Name:RABBANY
Last Name:EMRANI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 S SAN VICENTE BLVD
Mailing Address - Street 2:103
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4650
Mailing Address - Country:US
Mailing Address - Phone:310-435-8784
Mailing Address - Fax:310-274-9540
Practice Address - Street 1:566 S SAN VICENTE BLVD
Practice Address - Street 2:103
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-4650
Practice Address - Country:US
Practice Address - Phone:310-435-8784
Practice Address - Fax:310-274-9540
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT49508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist