Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 291388 | CA |
N | 225X00000X | Occupational Therapist | 14349 | CA |
NPI | 1003201245 |
---|---|
Provider Name | Negin Zare |
First Address | Midway City, CA 92655-1620 |
Second Address | Huntington Beach, CA 92648-1935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2015 |
Last Update Date | 14/10/2021 |