Healthcare Provider Details

I. General information

NPI: 1710663489
Provider Name (Legal Business Name): TINA NAFIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 S ANAHEIM BLVD STE 101
ANAHEIM CA
92805-6205
US

IV. Provider business mailing address

105 MASTERPIECE
IRVINE CA
92618-1378
US

V. Phone/Fax

Practice location:
  • Phone: 714-948-7641
  • Fax:
Mailing address:
  • Phone: 916-880-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: