Sorour Khalili | Yorba Linda, CA • PECOS Search

Sorour Khalili

Marriage & Family Therapist

Behavioral Health & Social Service Providers

17451 Bastanchury Rd Ste 204-25, Yorba Linda, CA 92886-1857

PECOS Enrollment

Based on the most recent information from CMS, provider Sorour Khalili does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1013173608
Provider Type
Individual
Full Name
Khalili, Sorour
Title
Mrs.
Credential
MFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/2/2008
Last Updated
8/2/2008

Contact Information

Practice Location

17451 Bastanchury Rd Ste 204-25, Yorba Linda, CA 92886-1857

Unlisted Fax

Mailing Location

17451 Bastanchury Rd Ste 204-25, Yorba Linda, CA 92886-1857

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFC31644 California