Provider Demographics
NPI:1417833658
Name:GOLBADI, LAAL MEHRI
Entity type:Individual
Prefix:
First Name:LAAL
Middle Name:MEHRI
Last Name:GOLBADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 E AVENIDA DE LOS ARBOLES # 337
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-1361
Mailing Address - Country:US
Mailing Address - Phone:818-734-9776
Mailing Address - Fax:
Practice Address - Street 1:2060 E AVENIDA DE LOS ARBOLES # 337
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-1361
Practice Address - Country:US
Practice Address - Phone:818-724-9776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty