Provider Demographics
NPI:1366961112
Name:KHOURAKI, AIMEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:AIMEN
Middle Name:
Last Name:KHOURAKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 REDONDO AVE # 197
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-8130
Mailing Address - Country:US
Mailing Address - Phone:323-484-4216
Mailing Address - Fax:
Practice Address - Street 1:23901 CALABASAS RD STE 1076
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1581
Practice Address - Country:US
Practice Address - Phone:818-538-5236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program