Basic Information
| Provider Information | |||||||||
| NPI: | 1609348093 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDULLAH | ||||||||
| FirstName: | HASSAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5250 HARMONY AVE APT 115 | ||||||||
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| City: | NORTH HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916013256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186413870 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16360 ROSCOE BLVD | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914061219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014830 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2018 | ||||||||
| LastUpdateDate: | 12/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | AMFT107711 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.