Provider Demographics
NPI:1851584312
Name:AZAD, RAANA FRYER (MS)
Entity Type:Individual
Prefix:MS
First Name:RAANA
Middle Name:FRYER
Last Name:AZAD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 SEABRIGHT LN
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1271
Mailing Address - Country:US
Mailing Address - Phone:858-755-8159
Mailing Address - Fax:858-755-2522
Practice Address - Street 1:2403 SAN MATEO BLVD NE
Practice Address - Street 2:SUITE S-14
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4058
Practice Address - Country:US
Practice Address - Phone:505-830-1871
Practice Address - Fax:505-830-0040
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor