Provider Demographics
NPI:1689233124
Name:MORADHASEL, RANA
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:MORADHASEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RANA
Other - Middle Name:
Other - Last Name:GHAEMMAGHAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1103 N B STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811
Mailing Address - Country:US
Mailing Address - Phone:916-532-7140
Mailing Address - Fax:
Practice Address - Street 1:1103 N B STREET
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811
Practice Address - Country:US
Practice Address - Phone:916-532-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X, 106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program