Provider Demographics
NPI:1457418592
Name:SADEGHI, MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 VISTA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-6506
Mailing Address - Country:US
Mailing Address - Phone:510-412-0902
Mailing Address - Fax:
Practice Address - Street 1:11417 W BERNARDO CT
Practice Address - Street 2:STE K
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1639
Practice Address - Country:US
Practice Address - Phone:858-254-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-18302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical