Provider Demographics
NPI:1982934071
Name:KALANTARI, ROZA
Entity Type:Individual
Prefix:MISS
First Name:ROZA
Middle Name:
Last Name:KALANTARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S DOHENY DR APT 1022
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2997
Mailing Address - Country:US
Mailing Address - Phone:310-592-9796
Mailing Address - Fax:
Practice Address - Street 1:100 S DOHENY DR APT 1022
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-2997
Practice Address - Country:US
Practice Address - Phone:310-592-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor