Provider Demographics
NPI:1982714143
Name:GHAHERI, FATEMEH SHIRIN (MD)
Entity Type:Individual
Prefix:DR
First Name:FATEMEH
Middle Name:SHIRIN
Last Name:GHAHERI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3671 BUSINESS DRIVE, SUITE #100
Mailing Address - Street 2:CAARE DIAGNOSTIC & TREATMENT CENTER
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-2165
Mailing Address - Country:US
Mailing Address - Phone:916-734-8399
Mailing Address - Fax:916-734-5644
Practice Address - Street 1:3671 BUSINESS DRIVE, SUITE #100
Practice Address - Street 2:CAARE DIAGNOSTIC & TREATMENT CENTER
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2165
Practice Address - Country:US
Practice Address - Phone:916-734-8399
Practice Address - Fax:916-734-5644
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA671842084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2888Medicaid