Healthcare Provider Details

I. General information

NPI: 1073890307
Provider Name (Legal Business Name): NAFISA SEKANDARI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15002 N 32ND ST
PHOENIX AZ
85032-4441
US

IV. Provider business mailing address

15002 N 32ND ST
PHOENIX AZ
85032-4441
US

V. Phone/Fax

Practice location:
  • Phone: 602-449-2081
  • Fax:
Mailing address:
  • Phone: 602-449-2081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4243
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: