Provider Demographics
NPI:1336380104
Name:BIRHANI, FATEMEH K
Entity Type:Individual
Prefix:
First Name:FATEMEH
Middle Name:K
Last Name:BIRHANI
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 1:19061 BARNHART AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3501
Mailing Address - Country:US
Mailing Address - Phone:408-517-0236
Mailing Address - Fax:
Practice Address - Street 1:19061 BARNHART AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3501
Practice Address - Country:US
Practice Address - Phone:408-517-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health