Provider Demographics
NPI:1750121372
Name:FALAHAT, NAZI (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:NAZI
Middle Name:
Last Name:FALAHAT
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 SAN RAMON VALLEY BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4031
Mailing Address - Country:US
Mailing Address - Phone:925-831-1283
Mailing Address - Fax:925-831-1283
Practice Address - Street 1:913 SAN RAMON VALLEY BLVD STE 280
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4031
Practice Address - Country:US
Practice Address - Phone:925-831-1283
Practice Address - Fax:925-831-1283
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
CAPSY18502103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent