Provider Demographics
NPI:1972323970
Name:MALEKI-PETROSSIAN, SALIN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SALIN
Middle Name:
Last Name:MALEKI-PETROSSIAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 HERMOSA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1801
Mailing Address - Country:US
Mailing Address - Phone:818-720-1396
Mailing Address - Fax:
Practice Address - Street 1:2331 HONOLULU AVE SUITE G/H
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020
Practice Address - Country:US
Practice Address - Phone:818-915-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT140225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist