Healthcare Provider Details

I. General information

NPI: 1710693999
Provider Name (Legal Business Name): BITA SARRAF ZADEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W SANTA ANA BLVD STE 600
SANTA ANA CA
92701-4552
US

IV. Provider business mailing address

1100 W TOWN AND COUNTRY RD STE 1250
ORANGE CA
92868-4633
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-4455
  • Fax:
Mailing address:
  • Phone: 949-357-2556
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: