Baharak Tavafifard, PSYD
Individual provider Active NPI Psychologist · Los Angeles, CA
NPI 1841929809 · NPPES record last updated Jun 6, 2022
Key facts
- NPI
- 1841929809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 33318 (CA)
- Practice address
- 11301 Wilshire Blvd
West la VA Building 217, Room 38
Los Angeles, CA 90073-1003 - Phone
- (310) 478-3711
- NPI assigned
- Jun 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33318 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 33318 | CA | Yes |
Addresses
Primary practice location
11301 Wilshire Blvd
West la VA Building 217, Room 38
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd
West la VA Building 217, Room 38
Los Angeles, CA 90073-1003
Phone (310) 478-3711
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- Amin Tavakoli
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All providers in Los Angeles, CA · Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.