Healthcare Provider Details

I. General information

NPI: 1972900850
Provider Name (Legal Business Name): MARJAN SADEGHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 1ST ST STE 345
SIMI VALLEY CA
93065-1553
US

IV. Provider business mailing address

2655 1ST ST STE 345
SIMI VALLEY CA
93065-1553
US

V. Phone/Fax

Practice location:
  • Phone: 805-864-9290
  • Fax: 805-864-9291
Mailing address:
  • Phone: 805-864-9290
  • Fax: 805-864-9291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: