Healthcare Provider Details

I. General information

NPI: 1972311181
Provider Name (Legal Business Name): FARZANEH SALEHI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 NORDAHL RD STE 300
SAN MARCOS CA
92069-3599
US

IV. Provider business mailing address

PO BOX 4062
ALAMEDA CA
94501-0401
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-8935
  • Fax:
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-421-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: