Healthcare Provider Details

I. General information

NPI: 1124972682
Provider Name (Legal Business Name): NATASHA TEHRANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 TECHNOLOGY DR
FREMONT CA
94538-6337
US

IV. Provider business mailing address

47000 WARM SPRINGS BLVD STE 135
FREMONT CA
94539-6814
US

V. Phone/Fax

Practice location:
  • Phone: 510-659-2514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number614D52EB1B
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: