Fariba Kooklan, M.S.LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

45702 Issued in CA

Practice address

17777 Ventura Blvd
Suite 103
Encino, CA 91316-3736

Phone

(818) 908-1233

Fax

(818) 908-1234

NPI assigned

Jan 23, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Fariba Kamkar Fassaie Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1508303025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD STE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163738",
            "telephone_number": "805-231-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD",
            "address_2": "SUITE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163736",
            "telephone_number": "818-908-1233",
            "fax_number": "818-908-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOKLAN",
        "first_name": "FARIBA",
        "credential": "M.S.LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARIBA",
            "last_name": "KAMKAR FASSAIE",
            "credential": "MS. LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stella Koletic, DDS
• Sepehr Koliny, DPT
• Paul Konikoff, M.D.
• Umi Kono, BCBA
• Naiereh Nina Koocheki
• Candace Kopel, PH.D.
• Stanley M Kopelow, MD
• E Barbara Koretz, B.C.D., L.C.S.W.
• Lara Kose, MD
• Ronald Ira Koslowski, DDS

• Marriage & Family Therapist in Encino, CA
• Providers in Encino, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.