Provider Demographics
NPI:1073360095
Name:AZIZI TALK THERAPY LLC
Entity type:Organization
Organization Name:AZIZI TALK THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZULYKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-300-9360
Mailing Address - Street 1:4768 RHAPSODY DR
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5579
Mailing Address - Country:US
Mailing Address - Phone:949-300-9360
Mailing Address - Fax:
Practice Address - Street 1:4768 RHAPSODY DR
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5579
Practice Address - Country:US
Practice Address - Phone:949-300-9360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1619549748OtherMARRIAGE AND FAMILY THERAPY