Provider Demographics
NPI:1750197679
Name:SAREENITY
Entity type:Organization
Organization Name:SAREENITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:SAREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHODABAKHSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-406-9957
Mailing Address - Street 1:11400 TERRA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-6526
Mailing Address - Country:US
Mailing Address - Phone:818-406-9957
Mailing Address - Fax:
Practice Address - Street 1:300 N 3RD ST # 319
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1107
Practice Address - Country:US
Practice Address - Phone:818-406-9957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder