Provider Demographics
NPI:1861032161
Name:DJAFARZADEH SMITH, PARNIAN
Entity Type:Individual
Prefix:MS
First Name:PARNIAN
Middle Name:
Last Name:DJAFARZADEH SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 KENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-2563
Mailing Address - Country:US
Mailing Address - Phone:415-488-7878
Mailing Address - Fax:
Practice Address - Street 1:291 SMITH RANCH RD
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2093
Practice Address - Country:US
Practice Address - Phone:415-492-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty