Provider Demographics
NPI:1871228999
Name:MOTAKEF, SAHAR (PSYD)
Entity type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:MOTAKEF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N CENTRAL AVE # A311
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2296
Mailing Address - Country:US
Mailing Address - Phone:714-612-0071
Mailing Address - Fax:
Practice Address - Street 1:11645 WILSHIRE BLVD STE 1030
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:714-612-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94025642103TC0700X
CA33883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical