Provider Demographics
NPI:1659493302
Name:SEWANI, MUNIR A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MUNIR
Middle Name:A
Last Name:SEWANI
Suffix:
Gender:M
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:PO BOX 56203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92517-1103
Mailing Address - Country:US
Mailing Address - Phone:951-295-0315
Mailing Address - Fax:
Practice Address - Street 1:1210 NEVADA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2895
Practice Address - Country:US
Practice Address - Phone:951-295-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12441103T00000X
CAMFT23533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist