Provider Demographics
NPI:1356060578
Name:JAVAHERIAN, AFSOON SARAH (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:AFSOON
Middle Name:SARAH
Last Name:JAVAHERIAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 ELVIDO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1111
Mailing Address - Country:US
Mailing Address - Phone:818-749-7113
Mailing Address - Fax:
Practice Address - Street 1:3213 ELVIDO DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1111
Practice Address - Country:US
Practice Address - Phone:818-749-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist