Provider Demographics
NPI:1750700233
Name:HESARI, MAHSA MESBAH (MA, BCBA)
Entity type:Individual
Prefix:
First Name:MAHSA
Middle Name:MESBAH
Last Name:HESARI
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15315 MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1173
Mailing Address - Country:US
Mailing Address - Phone:818-232-7940
Mailing Address - Fax:818-782-9985
Practice Address - Street 1:15315 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1173
Practice Address - Country:US
Practice Address - Phone:818-232-7940
Practice Address - Fax:818-782-9985
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1-14-15810103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst