Provider Demographics
NPI:1407239403
Name:AFSHAR, NEDA (FNP-C MSN)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:AFSHAR
Suffix:
Gender:F
Credentials:FNP-C MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 LAVERSTOCK WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-6119
Mailing Address - Country:US
Mailing Address - Phone:916-335-9373
Mailing Address - Fax:
Practice Address - Street 1:840 LAVERSTOCK WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864
Practice Address - Country:US
Practice Address - Phone:916-335-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily