Healthcare Provider Details

I. General information

NPI: 1346420445
Provider Name (Legal Business Name): ANAHITA FORATI DAOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 SOLANO AVE
ALBANY CA
94706-2124
US

IV. Provider business mailing address

PO BOX 9022
BERKELEY CA
94709-0022
US

V. Phone/Fax

Practice location:
  • Phone: 510-549-3000
  • Fax:
Mailing address:
  • Phone: 510-549-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12524
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002975
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: