Healthcare Provider Details

I. General information

NPI: 1689395568
Provider Name (Legal Business Name): AFIK FAERMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AFIK FAERMAN

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2275
LITTLETON CO
80161-2275
US

IV. Provider business mailing address

401 QUARRY RD
STANFORD CA
94304-4258
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-3021
  • Fax:
Mailing address:
  • Phone: 650-497-3021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0006627
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number0006627
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: