Provider Demographics
NPI:1033936653
Name:KADE, PAYAM TONY (LMFT)
Entity type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:TONY
Last Name:KADE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 DEERVALE DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-4610
Mailing Address - Country:US
Mailing Address - Phone:310-709-1102
Mailing Address - Fax:
Practice Address - Street 1:4025 DEERVALE DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-4610
Practice Address - Country:US
Practice Address - Phone:310-709-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist