MEDICARE: ALANNA SOFIA AFRASIABI

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1407591811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANNA SOFIA AFRASIABI

Provider Business Mailing Address
First Line	:	22105 CAMERON ST
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-6509
Country	:	US
Telephone Number	:	408-701-8903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4471 STONERIDGE DR
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-8404
Country	:	US
Telephone Number	:	408-701-8903
Fax Number	:

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

Provider Enumeration Date	:	04/29/2022
Last Update Date	:	04/29/2022

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Directions to “ ALANNA SOFIA AFRASIABI ” Practice Location

Language	Start Address	Practice Location

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