Provider Demographics
NPI:1558461368
Name:FARAHANCHI, PARISA (OTR/L)
Entity Type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:FARAHANCHI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 CAMINO TABLERO
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7444
Mailing Address - Country:US
Mailing Address - Phone:760-747-0490
Mailing Address - Fax:760-747-5777
Practice Address - Street 1:259 CAMINO TABLERO
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-7444
Practice Address - Country:US
Practice Address - Phone:760-747-0490
Practice Address - Fax:760-747-5777
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT2783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00439910OtherRAILROAD MEDICARE
CAWOT2783AMedicare PIN
CAP00439910OtherRAILROAD MEDICARE