Healthcare Provider Details

I. General information

NPI: 1750196457
Provider Name (Legal Business Name): PARIS PARASTOW ASHRAFI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 CHALLENGER WAY
SANTA ROSA CA
95407-5418
US

IV. Provider business mailing address

1014 HOPPER AVE # 130
SANTA ROSA CA
95403-1613
US

V. Phone/Fax

Practice location:
  • Phone: 707-565-4852
  • Fax:
Mailing address:
  • Phone: 310-999-8439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: