Provider Demographics
NPI:1891710661
Name:ATMAR, FARIHA (PA-C)
Entity Type:Individual
Prefix:
First Name:FARIHA
Middle Name:
Last Name:ATMAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-2239
Mailing Address - Country:US
Mailing Address - Phone:530-846-1400
Mailing Address - Fax:530-846-4762
Practice Address - Street 1:135 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2239
Practice Address - Country:US
Practice Address - Phone:530-846-1400
Practice Address - Fax:530-846-4762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18458363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA18458OtherPA LICENSE