Healthcare Provider Details

I. General information

NPI: 1326777590
Provider Name (Legal Business Name): SABREEN AZHAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 SCOTT BLVD
SANTA CLARA CA
95054-3316
US

IV. Provider business mailing address

3330 WOODSIDE LN
SAN JOSE CA
95121-1246
US

V. Phone/Fax

Practice location:
  • Phone: 855-554-2545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: