Provider Demographics
NPI:1891128062
Name:SEPEHRI, SARVENAZ (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARVENAZ
Middle Name:
Last Name:SEPEHRI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 UNIVERSITY AVE STE 144
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6706
Mailing Address - Country:US
Mailing Address - Phone:916-207-2867
Mailing Address - Fax:
Practice Address - Street 1:601 UNIVERSITY AVE STE 144
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6706
Practice Address - Country:US
Practice Address - Phone:916-207-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24252103T00000X, 103TC0700X
TX37232103TC0700X
CA28410103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist