Provider Demographics
NPI:1134792245
Name:TEHRAN, SAGHI (PMHN NP)
Entity type:Individual
Prefix:MS
First Name:SAGHI
Middle Name:
Last Name:TEHRAN
Suffix:
Gender:F
Credentials:PMHN NP
Other - Prefix:MS
Other - First Name:SAGHI
Other - Middle Name:
Other - Last Name:JAHANBAKHSH TEHRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHN NP
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:800-926-8273
Practice Address - Fax:888-539-8781
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182170363L00000X
CANP95018423363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty