Healthcare Provider Details

I. General information

NPI: 1346612116
Provider Name (Legal Business Name): ROYA SAFARI ZAMANIAN APRN,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 MOUNTAIN VISTA ST STE 104
HENDERSON NV
89014-2365
US

IV. Provider business mailing address

5395 RUFFIN RD STE 204
SAN DIEGO CA
92123-1338
US

V. Phone/Fax

Practice location:
  • Phone: 702-706-2236
  • Fax:
Mailing address:
  • Phone: 858-571-3630
  • Fax: 858-295-3948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN002630
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN002630
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95011956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: