Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 105195 | CA |
NPI | 1114537842 |
---|---|
Provider Name | Dr. Sepideh Rahmani |
First Address | Roseville, CA 95661-4602 |
Second Address | Lincoln, CA 95648-8473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2020 |
Last Update Date | 06/08/2020 |