Provider Demographics
NPI:1609092949
Name:ZARIFIFAR, SUDABEH JASMINE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:SUDABEH
Middle Name:JASMINE
Last Name:ZARIFIFAR
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:SODABEH
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:1899 JAMAICA WAY
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081
Mailing Address - Country:US
Mailing Address - Phone:760-696-1364
Mailing Address - Fax:714-838-2104
Practice Address - Street 1:1899 JAMAICA WAY
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:760-696-1364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000183-1106H00000X
CAMFC44871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC44871OtherLICENSED MARRIAGE, FAMILY, AND CHILD THERAPIST
NY000183-1OtherLICENSE MARRIAGE, FAMILY THERAPIST