Provider Demographics
NPI:1205498060
Name:OBAIDI, NAZIFA
Entity type:Individual
Prefix:
First Name:NAZIFA
Middle Name:
Last Name:OBAIDI
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 1:14940 SHETLAND LN
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-9453
Mailing Address - Country:US
Mailing Address - Phone:140-899-0610
Mailing Address - Fax:
Practice Address - Street 1:14940 SHETLAND LN
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-9453
Practice Address - Country:US
Practice Address - Phone:140-899-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No253J00000XAgenciesFoster Care Agency