Healthcare Provider Details

I. General information

NPI: 1598237380
Provider Name (Legal Business Name): YASAMAN MOKARRAMI TEHRANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 SIERRA LN
DUBLIN CA
94568-2796
US

IV. Provider business mailing address

5114 MOUNT TAM CIR
PLEASANTON CA
94588-3675
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-2281
  • Fax:
Mailing address:
  • Phone: 408-981-5602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: