Provider Demographics
NPI:1417673542
Name:JABARIPOUR, BEHNAZ (DPT)
Entity Type:Individual
Prefix:
First Name:BEHNAZ
Middle Name:
Last Name:JABARIPOUR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 BUTTE HOUSE RD STE D
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3109
Mailing Address - Country:US
Mailing Address - Phone:530-329-8490
Mailing Address - Fax:
Practice Address - Street 1:1103 BUTTE HOUSE RD STE D
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3109
Practice Address - Country:US
Practice Address - Phone:530-329-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303058208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation