Provider Demographics
NPI:1932559770
Name:HALIMI, HOMA
Entity Type:Individual
Prefix:
First Name:HOMA
Middle Name:
Last Name:HALIMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOMA
Other - Middle Name:HALIMI
Other - Last Name:NASSIRZADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:434 S SWALL DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3606
Mailing Address - Country:US
Mailing Address - Phone:310-733-9097
Mailing Address - Fax:
Practice Address - Street 1:14850 ROSCOE BLVD
Practice Address - Street 2:200
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4618
Practice Address - Country:US
Practice Address - Phone:310-733-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMCF49081106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist