MEDICARE: SUMAYYAH RAWASHDEH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	148262	CA

General Provider Information

NPI Number	:	1205726056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMAYYAH RAWASHDEH

Provider Business Mailing Address
First Line	:	3003 SCOTT BLVD STE 4
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 SCOTT BLVD STE 4
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3316
Country	:	US
Telephone Number	:	855-554-2545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2025
Last Update Date	:	07/03/2025

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