Provider Demographics
NPI:1275330136
Name:SYNERGY MARRIAGE FAMILY CHILD COUNSELLING SERVICES, INC
Entity type:Organization
Organization Name:SYNERGY MARRIAGE FAMILY CHILD COUNSELLING SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:820-444-0722
Mailing Address - Street 1:275 E HILLCREST DR # 160197
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5827
Mailing Address - Country:US
Mailing Address - Phone:820-444-0722
Mailing Address - Fax:
Practice Address - Street 1:275 E HILLCREST DR # 160197
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5827
Practice Address - Country:US
Practice Address - Phone:820-444-0722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAS MENTAL HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-27
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty