Healthcare Provider Details

I. General information

NPI: 1770922387
Provider Name (Legal Business Name): MS. ANAHITA SAADATIFARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14029 HARVEST AVE
NORWALK CA
90650-3740
US

IV. Provider business mailing address

8939 S SEPULVEDA BLVD STE 460
LOS ANGELES CA
90045-3653
US

V. Phone/Fax

Practice location:
  • Phone: 562-895-0860
  • Fax: 562-484-0802
Mailing address:
  • Phone: 310-337-7417
  • Fax: 310-337-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number93900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: