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General NPI Number Information
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NPI Number | 1013102771
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Entity Type | Individual
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Provider Name | FARAH NAZ PATHAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 455 SILICON VALLEY BLVD
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City | SAN JOSE
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State | CA
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Zip | 95138-1858
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Country | US
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Telephone | 669-900-1731
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Fax |
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Provider Business Mailing Address
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Address Line | 1376 BROOKLINE LOOP
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City | PLEASANTON
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State | CA
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Zip | 94566-3261
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C132429
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 036110488
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 36-110488
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License Number State | IL
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