Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 27414 | CA |
Y | 103T00000X | Psychologist | 27414 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 27414 | CA |
N | 103G00000X | Clinical Psychologist | 27414 | CA |
N | 103TC0700X | Clinical Psychologist | 27414 | CA |
N | 103TF0000X | Family Psychologist | 27414 | CA |
N | 103TP2701X | Group Psychotherapist | 27414 | CA |
NPI | 1275907719 |
---|---|
Provider Name | Dr. Rozalin Banafsheian |
First Address | Beverly Hills, CA 90209 |
Second Address | Los Angeles, CA 90004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2015 |
Last Update Date | 20/11/2015 |