Healthcare Provider Details

I. General information

NPI: 1982245650
Provider Name (Legal Business Name): SAHAR AFRAND FARIMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 MARIN ST STE 270
THOUSAND OAKS CA
91360-4112
US

IV. Provider business mailing address

1964 OBERLIN AVE
THOUSAND OAKS CA
91360-2048
US

V. Phone/Fax

Practice location:
  • Phone: 805-719-0244
  • Fax:
Mailing address:
  • Phone: 818-312-5789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95011855
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: