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General NPI Number Information
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NPI Number | 1669341921
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Entity Type | Individual
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Provider Name | FATEMEH DEHDAR
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Gender | Female
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1765 CHALLENGE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95815-5000
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Country | US
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Telephone | 916-905-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 MAMBO WAY
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City | ROSEVILLE
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State | CA
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Zip | 95747-4343
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Country | US
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Telephone | 510-305-1319
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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 | 2471M2300X
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Taxonomy Name | Mammography Radiologic Technologist
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License Number | RHM00078688
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License Number State | CA
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