Provider Demographics
NPI:1982786034
Name:ASADINIK, SAHAR DASTGERDI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:DASTGERDI
Last Name:ASADINIK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SAHAR
Other - Middle Name:MOKARI
Other - Last Name:DASTGERDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 CALIFORNIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-6472
Mailing Address - Country:US
Mailing Address - Phone:951-523-0507
Mailing Address - Fax:
Practice Address - Street 1:1101 CALIFORNIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-6472
Practice Address - Country:US
Practice Address - Phone:951-523-0507
Practice Address - Fax:951-905-1701
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27976103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical