Provider Demographics
NPI:1851128870
Name:SHAGHAYEGH HABIBI INC
Entity type:Organization
Organization Name:SHAGHAYEGH HABIBI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAGHAYEGH
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-307-6020
Mailing Address - Street 1:6521 WYSTONE AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-7611
Mailing Address - Country:US
Mailing Address - Phone:818-307-6020
Mailing Address - Fax:
Practice Address - Street 1:6521 WYSTONE AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-7611
Practice Address - Country:US
Practice Address - Phone:818-307-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison HealthGroup - Single Specialty