MEDICARE: FARRAH NURSING CORP

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	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1417831959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARRAH NURSING CORP

Provider Business Mailing Address
First Line	:	2021 FILLMORE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-2708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 HYDE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-1223
Country	:	US
Telephone Number	:	628-800-4081
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FARRAH SELAH JALLALVANDI
Credential	:	NP
Telephone Number	:	628-800-4081

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/05/2025

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