Healthcare Provider Details

I. General information

NPI: 1255522264
Provider Name (Legal Business Name): NAZINEH NEZHAD HUFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SAN CLEMENTE DR STE D-230C
CORTE MADERA CA
94925-1244
US

IV. Provider business mailing address

45 SAN CLEMENTE DR STE D230C
CORTE MADERA CA
94925-1244
US

V. Phone/Fax

Practice location:
  • Phone: 415-830-4833
  • Fax: 415-534-0826
Mailing address:
  • Phone: 415-830-4833
  • Fax: 415-534-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA100222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: