Provider Demographics
NPI:1467742668
Name:DADVAR, SEDIGHEH SHUKOFEH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SEDIGHEH
Middle Name:SHUKOFEH
Last Name:DADVAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 POLLARD RD STE 6
Mailing Address - Street 2:LOS GATOS
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1420
Mailing Address - Country:US
Mailing Address - Phone:408-219-0588
Mailing Address - Fax:
Practice Address - Street 1:812 POLLARD RD STE 6
Practice Address - Street 2:LOS GATOS
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1420
Practice Address - Country:US
Practice Address - Phone:408-219-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-09
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist