Souris, Sepideh A
Souris, Sepideh A is an sole proprietor health care provider with primary practice located at 21243 Ventura Blvd Ste 107 , Woodland Hills CA 91364-2123. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Souris, Sepideh A can be contacted via phone (310) 993-3620.Contact Information
Primary practice address
21243 Ventura Blvd Ste 107
Woodland Hills CA 91364-2123
Phone: (310) 993-3620
Fax: (747) 300-9246
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 14946 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY14946 | California |
Profile Details
| NPI number | 1518406875 |
|---|---|
| LBN Legal business name | Souris, Sepideh A |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2017 |
| Last updated | Jun 11th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518406875 | NPPES |
| California | Other | 14946 | PROFESSIONAL LICENSE |
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