Provider Demographics
NPI:1669063681
Name:NASSIRI, ARIANA (PA-C)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:NASSIRI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 MORELLO AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1860
Mailing Address - Country:US
Mailing Address - Phone:925-287-1256
Mailing Address - Fax:925-287-0913
Practice Address - Street 1:2250 MORELLO AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1860
Practice Address - Country:US
Practice Address - Phone:925-287-1256
Practice Address - Fax:925-287-0913
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA58882363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant