Provider Demographics
NPI:1902553654
Name:TAGHAVI, FARIMAH
Entity Type:Individual
Prefix:
First Name:FARIMAH
Middle Name:
Last Name:TAGHAVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PAULING CT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-4111
Mailing Address - Country:US
Mailing Address - Phone:949-881-7517
Mailing Address - Fax:
Practice Address - Street 1:2 PAULING CT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-4111
Practice Address - Country:US
Practice Address - Phone:949-881-7517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide