Healthcare Provider Details

I. General information

NPI: 1427441922
Provider Name (Legal Business Name): SAEMA RAHMANY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W BROADWAY STE 400
SAN DIEGO CA
92101-3554
US

IV. Provider business mailing address

2013 TIOGA PASS WAY
ANTIOCH CA
94531-9060
US

V. Phone/Fax

Practice location:
  • Phone: 925-726-9308
  • Fax:
Mailing address:
  • Phone: 925-726-9308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number30734
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number30734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: