Provider Demographics
NPI:1003386038
Name:KHOMJANI, ARIANE
Entity Type:Individual
Prefix:
First Name:ARIANE
Middle Name:
Last Name:KHOMJANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2762 HUTCHINSON CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4456
Mailing Address - Country:US
Mailing Address - Phone:415-446-8400
Mailing Address - Fax:
Practice Address - Street 1:22283 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4004
Practice Address - Country:US
Practice Address - Phone:800-249-4961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst