Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY31024 | CA |
Y | 103T00000X | Psychologist | PSY31024 | CA |
NPI | 1003448408 |
---|---|
Provider Name | Dr. Amy Hamideh Farhadzadeh |
First Address | West Hills, CA 91308-5085 |
Second Address | West Hills, CA 91307-2666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2020 |
Last Update Date | 04/02/2020 |