Provider Demographics
NPI:1477244127
Name:SAFRIWE, HADDY LEE
Entity Type:Individual
Prefix:
First Name:HADDY
Middle Name:LEE
Last Name:SAFRIWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 HUTCHISON DR APT 310
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-8203
Mailing Address - Country:US
Mailing Address - Phone:818-631-1400
Mailing Address - Fax:
Practice Address - Street 1:1721 HUTCHISON DR APT 310
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-8203
Practice Address - Country:US
Practice Address - Phone:310-910-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician