Provider Demographics
NPI:1295318129
Name:SAFINA, SARINA MAI LEE (NP)
Entity type:Individual
Prefix:MRS
First Name:SARINA
Middle Name:MAI LEE
Last Name:SAFINA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-1504
Mailing Address - Country:US
Mailing Address - Phone:650-339-4271
Mailing Address - Fax:
Practice Address - Street 1:125 SHOREWAY RD STE A
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2718
Practice Address - Country:US
Practice Address - Phone:650-556-9420
Practice Address - Fax:661-678-2779
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9507160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily