Provider Demographics
NPI:1649969007
Name:ROSHANI, FARNAZ (PHD)
Entity type:Individual
Prefix:DR
First Name:FARNAZ
Middle Name:
Last Name:ROSHANI
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 1:100 FOLSOM PRISON RD
Mailing Address - Street 2:
Mailing Address - City:REPRESA
Mailing Address - State:CA
Mailing Address - Zip Code:95671-0001
Mailing Address - Country:US
Mailing Address - Phone:916-477-1416
Mailing Address - Fax:
Practice Address - Street 1:100 FOLSOM PRISON RD
Practice Address - Street 2:
Practice Address - City:REPRESA
Practice Address - State:CA
Practice Address - Zip Code:95671-5201
Practice Address - Country:US
Practice Address - Phone:916-477-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program