Provider Demographics
NPI:1285393843
Name:AMIGHI, NAZILA (LMFT)
Entity type:Individual
Prefix:MR
First Name:NAZILA
Middle Name:
Last Name:AMIGHI
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 VAN NUYS BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5715
Mailing Address - Country:US
Mailing Address - Phone:310-927-0194
Mailing Address - Fax:
Practice Address - Street 1:4419 VAN NUYS BLVD STE 208
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5715
Practice Address - Country:US
Practice Address - Phone:310-927-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA94686106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81-3551716OtherFEDERAL