Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | IMF66273 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | CA | |
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1043507635 |
---|---|
Provider Name | Ms. Yasaman Mostajeran |
First Address | Los Angeles, CA 90034-3740 |
Second Address | Los Angeles, CA 90034-3740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 08/09/2020 |