Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY31584 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY31584 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1053787218 |
---|---|
Provider Name | Dr. Samin Seraji |
First Address | Northridge, CA 91325-2003 |
Second Address | Northridge, CA 91325-2003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2015 |
Last Update Date | 24/08/2020 |