Provider Demographics
NPI:1649903949
Name:BARAKZAI, ZERMENA SARA (THERAPY)
Entity type:Individual
Prefix:
First Name:ZERMENA
Middle Name:SARA
Last Name:BARAKZAI
Suffix:
Gender:F
Credentials:THERAPY
Other - Prefix:MISS
Other - First Name:ZERMENA
Other - Middle Name:SARA
Other - Last Name:BARAKZAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THERAPY
Mailing Address - Street 1:16052 BEACH BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3809
Mailing Address - Country:US
Mailing Address - Phone:714-655-5235
Mailing Address - Fax:
Practice Address - Street 1:17111 BEACH BLVD STE 205
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5947
Practice Address - Country:US
Practice Address - Phone:714-461-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty