Provider Demographics
NPI:1881744613
Name:HARBOR UCLA
Entity type:Organization
Organization Name:HARBOR UCLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC SOCIAL WORKER II
Authorized Official - Prefix:MS
Authorized Official - First Name:ZARI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARGARBASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:310-222-1648
Mailing Address - Street 1:1000 W CARSON ST BOX # 462
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90509
Mailing Address - Country:US
Mailing Address - Phone:310-222-1648
Mailing Address - Fax:310-222-5651
Practice Address - Street 1:1000 W CARSON ST # 462
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-1648
Practice Address - Fax:310-222-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23125273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit